Left Quadrants Research Articles

Buccolingual inclination of posterior dentition in maxillary impacted canine patients using quadrant analysis - A cone-beam computed tomographic study

BackgroundTo examine the buccolingual inclination of maxillary posterior teeth, curve of Wilson, and transversal dimensions in palatally impacted maxillary canine patients, compared to controls by cone-beam computed tomography (CBCT).Materials and methodsPre-treatment images of 22 bilateral, 32 unilateral impacted maxillary canine patients and 30 controls were included. All patients had palatally impacted canines, with no posterior cross-bite. Data were reclassified in quadrants according to the presence of impaction, as the impaction quadrant (right and left quadrants of 22 bilateral impacted cases, and quadrants presenting impaction of 32 unilateral cases, n = 76), unaffected quadrant (quadrant without impaction in 32 unilateral cases, n = 32) and the control quadrant (right and left quadrants of 30 controls, n = 60) to evaluate the buccolingual inclination angle, transversal width, and arch perimeter. Additionally, comparisons were made regarding curve of Wilson and total arch perimeter among bilateral and unilateral impaction groups with the control group. Statistical analysis was performed by one-way ANOVA and Kruskal Wallis tests. Tukey or Dunn tests were used for comparisons between groups in pairs.ResultsNo significant difference was found for the buccolingual inclination of maxillary posterior teeth and curve of Wilson among groups. The buccolingual inclination of canines in the impaction quadrant was significantly lower than the other quadrants (p < 0.001). Basal bone width at the level of second premolars, and alveolar width at both premolars were significantly narrower in the impaction quadrant than in the unaffected quadrant (p < 0.05). Dental arch width at the level of first premolar was significantly decreased in the impaction quadrant compared to other quadrants (p < 0.05). Arch perimeter was significantly reduced in the impaction quadrant than in the unaffected quadrant (p < 0.05).ConclusionThe presence of bilateral or unilateral palatally impacted maxillary canines did not effect the buccolingual inclination of posterior teeth, and curve of Wilson. Transverse discrepancy was evident in the impaction quadrant even in the absence of posterior cross-bite. Quadrant analysis was particularly useful in evaluating asymmetry for basal bone and alveolar bone widths in the premolar region in patients with unilateral palatally impacted maxillary canine patients.

Impact of Local Melatonin Application on Expression Level of Osteogenic Marker (Runx2) and Post-orthodontic Relapse in Ovine Model: A Split Mouth Study

Background: Retaining teeth in their proper alignment after orthodontic treatment can be highly challenging. This study aimed to estimate the effectiveness of locally injected melatonin in improving bone remodelling and reducing post-orthodontic relapse. Methods: The third incisors on the right and left quadrants of six sheep were removed and the second and fourth incisors were brought close together by using a sectional orthodontic appliance. Melatonin solution was injected near and parallel to the mesial surface of the second incisor and the distal surface of the fourth incisor on one quadrant while the other quadrant received 1% dimethyl sulphoxide as a control. Four weeks later, the orthodontic appliance was debonded and the teeth were allowed to move back. By utilizing digital analysis, the relapse distance of the approximated incisors was measured at 21 and 42 days respectively after appliance removal. Histological and mRNA expression analysis of osteogenic marker (Runx2) were conducted to evaluate the periodontal space width and the surrounding alveolar bone of the melatonin-treated and control side incisors. Result: clinical and histological measurements showed that the approximated incisors in the melatonin-treated quadrant had a significantly shorter relapse distance (p≤0.05), significantly smaller periodontal ligament width (p≤0.05) and significantly larger new bone area formation (p≤0.05) than in the control quadrant. The mRNA expression level of the osteogenic marker (Runx2) was significantly larger (p≤0.05) in the melatonin-treated quadrant than in the control quadrant. The outcomes of this research suggest that melatonin can enhance bone remodelling and reduce post-orthodontic relapse in sheep.

Evaluation of Focused Assessment With Sonography for Trauma Completeness of Children in the Clinical Setting.

We evaluated the completeness of real-world Focused Assessment with Sonography for Trauma (FAST) in children after blunt abdominal trauma by benchmarking against established expert guidelines. We conducted a retrospective cohort study, analyzing a random sample of FASTs from two urban pediatric emergency departments. Two experts reviewed and labeled all FASTs for completeness using a predefined guideline of 5 anatomic views and 30 landmarks. We compared frequencies of views and landmarks as medians with interquartile ranges. We analyzed 200 FASTs, consisting of 1636 video clips, performed by 31 clinicians representing 198 children with a median age of 10 years (IQR 5,14). Over half of FASTs (52%) had all 5 views. The right upper quadrant view was most commonly visualized (96.5%), and suprapubic sagittal was least (65%). None of the FASTs included all 30 landmarks, ranging from 0 to 28 and median of 19 (IQR 15,23). The least visualized landmark of the right and left upper quadrants was caudal liver edge (60%) and splenic tip (64%), respectively. In the pericardial view, it was left atrium (45%). In both transverse and sagittal pelvic views, retro-uterine space was least visualized in girls, 21 and 29% respectively. In our study, most FAST views and landmarks were visualized. However, the pelvic sagittal view was the least frequently visualized view, and caudal liver edge was the least visualized landmark. Future research should evaluate if variability in visualizing FAST views and landmarks correlates with inconsistencies in diagnostic test performance.

Collateral after Splenic Vein Thrombosis

A 46-year-old man presented to the emergency department because of relapsing abdominal pain in the left abdominal quadrants. At admission, he was in good general condition and his vital signs were normal. The only abnormal laboratory findings were a C-reactive protein of 30 mg/L and thrombocytes of 127 G/L. An abdominal computed tomography (CT) scan showed a thrombosis of the distal splenic vein (panel A, double arrow) with the presence of a superior and an inferior spleno-mesenteric collateral (panel A, asterisks). The axial CT scan (panel V, arrows) and Doppler sonography (panel C) showed that the thick collaterals developed below the abdominal wall. A gastroscopy showed stage I fundic varices, but no esophageal varices. (1-10) This patient was diagnosed with a smoldering multiple myeloma 5 years earlier with regular follow-up in the hemato-oncology department. No other pro-thrombotic conditions were found and in a follow-up CT scan 6 months later the findings were un-changed despite anticoagulation. Splenic vein thrombosis is frequently diagnosed in the chronic stage, when collaterals have already developed (11-18). In this case, the presence of two major spontaneous shunts between the splenic vein and the superior mesenteric vein is preventing complications (19-23) such as porto-systemic encephalopathy and variceal bleeding

Wave Spectra Analysis on the Spatiotemporal Variability of Sea States under Distinct Typhoon Tracks in a Semienclosed Sea

Abstract The dynamics of typhoon-induced waves in semienclosed seas become an interesting topic with the increase of typhoon intensity. Based on the calibrated Simulating Waves Nearshore (SWAN) model, wave dynamics were investigated under distinct typhoon tracks [e.g., Matmo (2014), Rumbia (2018), and Lekima (2019)] in the Bohai Sea. Distributions of significant wave heights (SWHs) are affected by the typhoon wind fields and are directly related to the typhoon tracks. The classical JONSWAP wave spectra were adopted for the analysis of sea states (e.g., wind seas or swells) to further explain variations in wave heights. Results indicate that the dominant sea state with higher energy experiences significant spatiotemporal variability under distinct tracks. For typhoons passing through the central part of the Bohai Sea (e.g., Rumbia), high-energy waves are observed under swell-dominated and mixed sea states, which are subjected to the fetch limitation in the semienclosed sea and rapid changes in typhoon winds. The high energy waves induced by other typhoons passing along the edges of the Bohai Sea correspond to the wind-sea-dominated sea state. Spatiotemporal variability of the sea state exhibits a high correlation with its position relative to the typhoon center. Therefore, a reference frame based on the radius of the maximum wind speed was established to discuss the sea states in this semienclosed sea. Further investigations reveal that swells (wind seas) dominate the regions within the radius of the maximum wind speed (elsewhere), and the double-peaked wave spectra tend to appear in the left quadrants.

A Novel Peritoneal Packing Method for Management of Hyperkalemia During Acute Kidney Injury in Trauma.

United States Military operations in resource limited areas are increasing. Furthermore, future peer or near-peer conflicts will require caring for larger numbers of casualties with limited resources. In this setting, traditional renal replacement therapy is not feasible and novel methods are required to address severe acute kidney injury in austere environments lacking definitive therapies. Here, we describe experiments designed to determine the efficacy of a novel peritoneal packing material (Potassium Binding Pack-PBP, CytoSorbents INC) for the acute management of severe hyperkalemia. Male swine (52 ±1 kg) were nephrectomized via midline laparotomy under a plane of anesthesia and randomized into one of two experimental groups (PBP & CON). Exogenous potassium was infused to achieve a serum potassium level of 7.5 mEq/L. Novel potassium absorbing packs (PBP) or sham packs (CON) were placed in the right and left upper quadrants, and the right and left paracolic gutters of the abdomen to simulate four-quadrant packing (n = 6, n = 5, respectively). Two liters of peritoneal dialysis fluid was instilled into the abdomen and temporary closure performed. Animals were observed for 12 hours. Serum and peritoneal fluid (dialysate) potassium levels were sampled at T = 15, 30, 60 min, and Q60min thereafter. Animals were humanely euthanized at the end of the observation period. Baseline characteristics were similar between groups. Pairwise analysis showed that serum potassium concentrations were significantly lower in the PBP group compared to CON at T = 540 and T = 720 (P = 0.006 and P = 0.015, respectively). Potassium concentrations were significantly lower in dialysate of the PBP group compared to CON at all time points after T = 15 (T = 30, P = 0.017; T = 60 through T = 720, P < 0.001). This is the first demonstration of an effective technology for the management of hyperkalemia in trauma in the absence of standard of care; renal replacement therapy. We identified that PBP was able to consistently maintain a concentration gradient between dialysate in the peritoneum and system potassium concentration throughout the experiment. Furthermore, systemic potassium concentrations were reduced in a clinically relevant manner in the PBP group compared to CON. This suggests that peritoneal packing technology for the management of metabolic disturbances in trauma has potential for clinical application. These results are preliminary and should be interpreted with caution.

Clinical analysis of nonsyndromic oligodontia phenotypes.

To provide references, this study investigated the clinical characteristics of patients with nonsyndromic oligodontia. The information of 178 patients with oligodontia was collected, including histories, oral examinations, and panoramic radiographs. Tooth agenesis characteristics were calculated and evaluated. All the data were statistically analyzed with SPSS 24.0 software. No significant difference in the number of missing teeth was found between sexes nor between the right and left sides, and congenitally missing teeth affected the maxillary arch (P<0.05). The highest prevalence of tooth agenesis was observed in the mandibular second premolars. In the maxillary arch, the most common pattern of tooth agenesis was agenesis of the bilateral first and second premolars. The agenesis of the bilateral second premolars was observed in the mandibular arch. The prevalence of a symmetric pattern between the right and left quadrants was significantly higher than that of matched patterns between the maxillary and mandibular antagonistic quadrants. Approximately 16.85% of patients with nonsyndromic oligodontia were affected by other tooth-related anomalies. The common patterns of tooth agenesis were successfully identified in patients with nonsyndromic oligodontia. Dentists need to provide multidisciplinary treatments for patients with nonsyndromic oligodontia because of variations in occluding and full-mouth tooth agenesis patterns.

A Cone‐Beam Computed Tomography Evaluation of C‐Shaped Canal Configuration in Maxillary Molars Among an Iranian Population

Objectives: This study aimed to assess the prevalence and configuration of C‐shaped canal morphology in maxillary molars in an Iranian population residing in Kermanshah Province of Iran using cone‐beam computed tomography (CBCT).Materials and Methods: This cross‐sectional study was conducted on 2290 CBCT scans of 804 maxillary first molars, 1049 maxillary second molars, and 437 maxillary third molars. The Maxillary Upper‐C Classification System was used for the detection of C‐shaped canal morphology, and the classification by Jo et al. was used for assessment of the configuration of C‐shaped canals. Data were analyzed by the Chi‐square test (α = 0.05).Results: The prevalence of C‐shaped canals in the maxillary first, second, and third molars was 1%, 7%, and 9%, respectively. Type III other types (B‐P) was the most frequent configuration followed by type I subtype C (MB‐DB). The prevalence of C‐shaped canal morphology was not significantly different among different age groups (p &gt; 0.05); however, its prevalence in females was almost twice that in males (p &lt; 0.05). The prevalence of C‐shaped canals was not significantly different in the right and left quadrants (p = 0.099). The most frequent configuration was type I subtype B (DB‐P) in males, and type III other types (B‐P) in females (p = 0.364).Conclusion: The prevalence of C‐shaped canals in maxillary first, second, and third molars was 1%, 7%, and 9%, respectively. C‐shaped canals were more common in females, and type III other types (B‐P) was the most frequent configuration in our study population.

Evaluation of the Effect of Occlusal Calibration in Periodontitis Patients with Occlusal Trauma Using T-Scan

Abstract Background: High occlusal forces in patients with untreated periodontitis may reflect occlusal trauma-associated periodontal conditions. Occlusal analysis using T-scan might provide the distribution of occlusal loading forces in periodontitis patients. The study aimed to evaluate the effect of occlusal trauma in periodontitis patients and occlusal calibration using a T-scan. Materials and Methods: A total of 30 periodontitis patients were recruited for the study. Patients were categorized into two groups: Group I: scaling and root planing followed by T-scan recording and no occlusal calibration; Group II: scaling and root planing followed by occlusal calibration using T-scan. Clinical parameters, orthopantomogram (OPG) and T-scan evaluation were evaluated at baseline, 3-month and 6-month intervals. Results: Significant improvements in clinical parameters were noted at different time intervals after occlusal calibration using T-scan. At 3-month intervals, mean pocket depth showed statistically significant difference among the test group in the right (upper and lower) and left lower quadrant at P = 0.01, 0.002 and 0.005, respectively. Mean clinical attachment level (CAL) showed statistically significant difference among the test group in the right upper, right lower and left lower quadrants at P = 0.02, 0.001 and 0.009, respectively, at 3 months. The comparison of the mean gingival index (GI) at 6 months showed statistically significant difference among test and control groups at 6 months in different study quadrants (P = 1 in right upper, 0.009 in right lower, &lt;0.001 in left upper and &lt;0.001 in left lower). Mean pocket depth at the 6-month follow-up showed statistically significant difference among the test group in all the study quadrants (P = &lt;0.001 in right upper, &lt;0.001 in right lower, 0.003 in left upper and 0.005 in left lower). Mean CAL showed statistically significant difference among the test group in all the study quadrants at 6-month intervals (P = 0.02 in right upper, &lt;0.001 in right lower, 0.01 in left upper and 0.04 in left lower). The bone defect height showed a statistically significant difference only in the right upper quadrant among both the test groups at the 6-month follow-up (P = 0.02). Comparing the mean percentage of force on both sides of the jaw showed a statistically significant difference among the test group at 6 months (P = 0.001 on the left side and 0.001 on the right side). Conclusion: The occlusal correction using T-scan showed a positive association between probing pocket depth (PPD) and CAL at different time intervals from baseline to 6 months when these parameters were compared after occlusal adjustments.

THU534 Humoral Hypercalcemia Of Malignancy As Initial Presentation Of Hepatocellular Carcinoma And Monoclonal Gammopathy Of Undetermined Significance

Abstract Disclosure: F. Jovanovic: None. A. Raghavan: None. A. Sudhakar: None. Background: Humoral hypercalcemia of malignancy can be initial metabolic manifestation of different neoplasms, and it is exceedingly rare in hepatocellular carcinoma (HCC).1 In this case report, we present a patient with humoral hypercalcemia secondary to HCC and monoclonal gammopathy of undetermined significance (MGUS) in the context of nonalcoholic steatohepatitis. Case Report: A 73-year-old Caucasian male with liver cirrhosis secondary to nonalcoholic steatohepatitis presented to the emergency department with a two-week history of constipation and progressive confusion. The patient was jaundiced on exam and tender to palpation in left and right middle abdominal quadrants. Laboratory findings on admission showed serum calcium 12.7 mg/dL (7.9–10.6), albumin 2.6 g/dL (3.5–5), platelets 85x103/µL (138–338), alkaline phosphatase 349 unit/L (50–136), alanine aminotransferase 234 unit/L (15-53), aspartate aminotransferase 133 unit/L (15–37), alpha-fetoprotein 1912.7 ng/mL (0–8), parathyroid hormone &amp;lt;3 pg/mL (14–72), and ammonia 40 mmol/L (11–32). The patient’s altered mental status improved with lactulose and rifaximin. Serum calcium levels persisted despite lactated Ringer’s solution, but improved with zoledronic acid 5 mg infusion to a nadir of 9.1 mg/dL during the hospital stay. The patient was administered repeat zoledronic acid before discharge, but was readmitted 5 days later with worsening mental status and corrected serum calcium 13.1 mg/dL. The CT abdomen and pelvis showed a mass (4.2 x 3.7 cm) in the lower right hepatic lobe. The send out labs returned with PTH-related peptide 48 pg/mL (11–20), 1,25 hydroxyvitamin D 20 pg/mL (20–45), and serum protein electrophoresis with a monoclonal M spike 1.33 g/dL in the gamma globulin region. The patient’s hypercalcemia was found to be PTH–independent and with the new hepatic mass on CT imaging, he was diagnosed with MGUS and humoral hypercalcemia secondary to HCC. The literature review shows only one case report with alcoholic cirrhosis and similar clinical presentation, which is in contrast to nonalcoholic steatohepatitis as seen in our patient.2 The patient’s family refused further treatment and opted for hospice care. Conclusion: We recommend that the patients with HCC and resistant hypercalcemia undergo diagnostic evaluation for monoclonal paraprotein as part of humoral hypercalcemia workup.

Lip print patterns in forensic investigation: Detectability, sex differentiation, and reliability

Lip print patterns are increasingly recognized as a vital resource within forensic investigations, providing a distinctive means for identifying individuals. This extensive investigation examines the detectability, possibility for sex distinction and forensic consequences of lip print patterns. Through both direct visualization and scoring procedures, a comprehensive examination was undertaken to analyze the intricate patterns of lip prints exhibited by male and female participants in Indonesia. The results of our study provide clear evidence for the infrequency of similar lip print patterns among individuals, confirming previous research conducted by Suzuki and Tsuchihashi. It is worth mentioning that type II lip print type was the prevailing type in Indonesian males and females. Furthermore, noticeable variances based on sex were seen in the upper left (UL) and lower middle (LM) quadrants. This research emphasizes the crucial significance of lip prints in criminal investigations, emphasizing their wide range of uses and relevance in diverse forensic contexts. The distinctiveness, singular nature, consistency, genetic transmission, and wide range of lip lines establish them as dependable means for personal identification. Lip print analysis has promise as a prospective means of scientific validation in forthcoming legal procedures, with the capacity to augment forensic methodologies and offer valuable contributions to the judicial process. The results reported in this study provide a foundation for creating a comprehensive set of criteria for assessing the lip line, which can serve as a valuable tool for the progression of forensic science and the pursuit of justice.

Assessment of crown dimensions of primary teeth in a selected sample of Indian children - An odontometric study

Abstract Introduction: The size and shape of the tooth are important sources of information for anthropology, forensic odontology, and clinical dentistry. Different populations, and even individuals within the same population, may have variations in the odontometric characteristics of their teeth, which limits the applicability of the data across groups. Aim: To establish the normal odontometric data of primary teeth and examine the sexual dimorphism and its usefulness as a tool to identify the sex among young children. Materials and Methods: This cross-sectional study involved 150 children aged 3–5 years. The parents of the selected children were informed about the procedure protocol of the study and their written consent was obtained. The negative replica of the maxillary and mandibular teeth was obtained and dental casts were prepared. The mesiodistal, buccolingual, and crown height dimensions of each tooth were measured with a digital Vernier caliper. Two independent examiners measured each tooth’s dimensions three times, and the mean was analyzed. Results and Discussion: There was no significant difference between the teeth in the right and left quadrants. Males had larger odontometric dimensions than females. The sex of children based on odontometrics of primary teeth crowns could be determined with an accuracy of 98%, 72%, and 86% using mesiodistal, buccolingual, and crown height dimensions, respectively. Conclusions: There was a clear sexual dimorphism of the primary teeth. The odontometrics can be used as a low-cost and alternative tool for sex identification among children.

Effects of Oleuropein Oral Intake on Infected Fat Grafts: Experimental Study.

The aim of this study was to evaluate the effects of oleuropein oral intake on infected fat grafts and fat graft survival. 32 Wistar albino rats were divided into four groups: 0. none treated, 1. serum oral intake, 2. antibiotic oral intake, and 3. oleuropein oral intake. The dorsal regions of the rats were separated into four quadrants as right and left cranial, and right and left caudal to determine each quadrant where fat grafts were placed. Right cranial and caudal quadrants were infected with the methicillin-susceptible Staphylococcus aureus (MSSA) strain. The left cranial and caudal quadrants were infected with the Pseudomonas aeruginosa strain. On the 7th day and end of the 3rd month, fibroblast density, inflammation, and fat survival were demonstrated immunohistochemically with FGF, CD68, and perilipin (PP), respectively. On the 7th day, for P. aureginosa-infected grafts, oleuropein was shown higher rates in CD68 and PP staining compared to the antibiotic group (p<0.05, p<0.001, respectively). At the end of the 3rd month, for P. aureginosa and S. aureus-infected grafts, the oleuropein group was demonstrated improved PP staining rates compared to the antibiotic group (p<0.01, p<0.01, respectively). Oleuropein as a natural olive leaf extract with potent antioxidant, anti-inflammatory, and antimicrobial features is an alternative and supportive agent for both treatment and prophylaxis of surgical site infections like the antibiotics of chemical synthesis. P. aeruginosa and S. aureus surgical site infections could treat and prevent safely and effectively by oleuropein, particularly in early and late periods after surgery. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Laparoscopic evaluation of nonspecific vague abdominal pain

Objective: To find out if laparoscopy has any diagnostic utility for individuals with non-specific, vague abdominal discomfort. Methodology: Laparoscopies for diagnosis were performed on patients who complained of vague, nonspecific stomach discomfort. SPSS version was used to gather and evaluate the data. Three months of patient follow-up occurred in the OPD. Results: There were 50 patients listed for the study where men outnumber women by a factor of 2. Individuals were between the ages of 20 and 60, having an average age of 36.0. Umbilical pain affected more than 50% of patients, followed by lower-body discomfort in the right (25%) and left (10%) quadrants. While some individuals had abdominal TB, 30% of the patients had appendicular pathology. About 13% of individuals experienced chronic and recurrent cholecystitis, and 11% had postoperative adhesions and bands. Wound infections made up 8% of the postoperative complications of the operation, whereas RTI made up 5%, 5 % of patients were diagnosed to have torsion of ovarian cyst, and 5 patients were diagnosed to have pelvic inflammatory disease. In 95% of the instances, a firm diagnosis was made.

Estimating Preterm Lung Volume: A Comparison of Lung Ultrasound, Chest Radiography, and Oxygenation

To determine the relationship between lung ultrasound (LUS), chest x-ray (CXR), radiographic and clinical evaluation in the assessment of lung volume in preterm infants STUDY DESIGN: In this prospective cohort study LUS was performed before CXR on 70 preterm infants and graded using: 1. a LUS score; 2. an atelectasis score; and 3. measurement of atelectasis depth. Radiographic diaphragm position and radio-opacification were used to determine global and regional radiographic atelectasis. The relationship between LUS, CXR, and oxygenation was assessed using receiver operator characteristics (ROC) and correlation analysis. LUS scores, atelectasis scores, and atelectasis depth did not correspond with radiographic global atelectasis (area under ROC curves [95% CI]: 0.54[0.36,0.71], 0.49[0.34,0.64], 0.47[0.31,0.64], respectively). Radiographic atelectasis of the right upper, right lower, left upper, and left lower quadrants was predicted by LUS scores (0.75[0.59,0.92], 0.75[0.62,0.89], 0.69[0.56,0.82], 0.63[0.508,0.751]) and atelectasis depth (0.66 [0.54,0.78], 0.65[0.53,0.77], 0.63[0.50,0.76], 0.56[0.44,0.70]). LUS findings were moderately correlated with oxygen saturation index (ρ=0.52[0.30,0.70]) and saturation to fraction of inspired oxygen ratio (ρ=-0.63[-0.76,-0.46]). The correlation between radiographic diaphragm position, oxygenation saturation index, and SpO2 to FiO2 ratio was very weak (ρ=0.36[0.11,0.59] and ρ=-0.32[-0.53,-0.07] respectively). LUS assessment of lung volume does not correspond with radiographic diaphragm position preterm infants. However, LUS predicted radiographic regional atelectasis and correlated with oxygenation. The relationship between radiographic diaphragm position and oxygenation was very weak. While LUS may not replace all radiographic measures of lung volume, LUS more accurately reflects respiratory status in preterm infants.

MPOX: Typical lesions in unusual places

A 54-year-old man seeks the Emergency Room due to a three-day course of left flank and left iliac pain. He had a past medical history of type 2 diabetes mellitus and splenectomy seven years ago. He denied fever and showed no signs of bowel obstruction. Pain was worsened upon palpation of the left quadrants. Digital rectal exam was unremarkable and there were no skin or ocular lesions on the physical exam.

OCT Findings in Patients with Methamphetamine Use Disorder.

In the present study, the purpose was to examine the results of optical coherence tomography (OCT) measurements in patients diagnosed with methamphetamine use disorder (MUD) by comparing them with healthy controls. A total of 114 eyes were evaluated in this study (27 patients and 30 control group participants). After detailed biomicroscopic examinations of all participants by the same ophthalmologist, both eyes were evaluated by OCT. The retinal nerve fiber layer thickness (RNFL) and macular thickness were calculated from OCT. No statistically significant differences were detected between the demographic data of the patient and control groups (p > 0.05). When OCT findings were evaluated, macular thickness and volume were not different between the groups (p > 0.05). With respect to RNFL, the left eye superior, inferior, temporal, and nasal quadrants, as well as the left eye's total measurements were found to be thicker than those of controls (p < 0.05). In both eyes, the left eye nasal quadrant and APIS total score were negatively correlated, the total RNLF measurement of the right eye and APIS motivation subscale score were negatively correlated, central macular thickness and the APIS motivation subscale score were positively correlated, and the APIS substance use characteristics subscale score and left eye temporal quadrant RNLF measurement were positively correlated. Our study is the first to evaluate addiction severity and OCT findings in MUD. However, this study needs to be supported by further studies so that OCT findings, which can be used as an effective method for demonstrating possible neurodegeneration in methamphetamine use disorder, gain importance.

Retinal nerve fiber layer thinning found in amyotrophic lateral sclerosis - Correlation with disease duration and severity.

The retinal involvement of amyotrophic lateral sclerosis (ALS) is a novel idea about a possible correlation between retinal nerve fiber layer (RNFL) thickness in different spectra of ALS patients. Finding the association of RNFL with disease duration and severity will help identify a novel noninvasive biomarker. The study was designed as a cross-sectional study and was conducted with a suitable proforma. We included the ALS cases based on the revised El Escorial criteria. Healthy controls were age and gender matched. We used the revised ALS functional rating scale (ALSFRS-R) to assess the operational status of the patients. We measured RNFL thickness in the four quadrants with spectral-domain optical coherence tomography (OCT) and analyzed it. We included 30 cases (60 eyes) and 10 healthy controls (20 eyes) having a mean (standard deviation [SD]) age of 49.5 (11.1) years with a median of 50 years, and a majority of them (65%) were middle aged (between 41 and 60 years). We found statistically significant differences in RNFL thicknesses between ALS patients and healthy controls. On segmental analysis, the right eye superior and nasal quadrants and the left eye superior, inferior, and nasal quadrants were significantly affected, along with a gross asymmetry found between the left and right eyes among ALS patients. There was a significant decrease in average RNFL thickness in definite ALS patients than probable ALS patients, with significantly reduced average RNFL thickness in moderate to severe ALS patients. On correlation analysis, disease duration showed a good negative correlation with bilateral average RNFL thickness, and the ALSFRS-R score demonstrated a good positive correlation with bilateral average RNFL thickness, which was statistically significant. Thus, a reduced bilateral RNFL thickness is associated with a decreased ALSFRS-R score. The retinal changes can serve as a marker for diagnosing and monitoring patients with ALS.

Gingival Depigmentation by Application of Diode Laser at 810 nm (Denlase) and 470 nm (Bluelase) Wavelengths: A Split-mouth Randomised Clinical Trial

Introduction: Gingival hyperpigmentation is a common aesthetic concern that often requires treatment to achieve a pleasing smile. While various methods for depigmentation have been described in the literature, the scalpel method is widely advocated. Laser technology, particularly diode lasers, has emerged as a preferred treatment option due to their unique properties. Aim: To compare the efficacy of two different diode wavelengths, namely Denlase and Bluelase lasers, in terms of pain intensity, aesthetic appraisal, and the rate of repigmentation. Materials and Methods: This split-mouth randomised clinical trial was conducted in the Department of Periodontics at Vishnu Dental College, Bhimavarm, Andhra Pradesh, India. over a period of one year with follow-up. A total of 16 patients were included, and the right and left quadrants (both maxilla and mandible) were randomly assigned to either the Denlase or Bluelase group using the coin toss method. Depigmentation using diode lasers at 810 nm and 470 nm wavelengths was carried out in the respective groups. Pain perception, aesthetic appraisal, and recurrence of pigmentation were evaluated at 1, 3, 6, 9 months, and one year. The data were analysed using Friedman’s analysis and the Mann-Whitney U-test. Results: A total of 16 subjects, with a mean age of 27.64±7.64 years and of both genders, were included in the study. Statistically significant differences (p=0.001) were reported in pain perception, aesthetic appraisal, and the rate of repigmentation at 1, 3, 6, 9 months, and one year, respectively. Intergroup comparison revealed an increase in the mean amount of repigmentation at three months in the Denlase group, indicating a recurrence of pigmentation after three months. Conclusion: The Bluelase diode laser (470 nm) demonstrated superior results compared to the Denlase diode laser (810 nm) in terms of pain intensity, aesthetic appraisal, and repigmentation.

Effect of periodontal dressing on the clinical outcomes of non-surgical periodontal treatments; A randomized controlled trial.

Objective: To study the effectiveness of periodontal dressing on different clinical periodontal parameters after scaling and root planning. Study Design: Randomized Controlled Trial. Setting: Department of Periodontology, Multan Medical &amp; Dental College, Multan. Period: May to July 2020. Material &amp; Methods: Thirty three patients of both genders between ages 30-60 were included. Five clinical parameters were measured at baseline. These variables were recorded by University Of Michigan “O’’ Probe with William’s Markings. The measurements were executed by a single, trained and calibrated examiner. Right and left quadrants of Maxilla and Mandible of the same patient were selected as the test and control sites respectively through random selection by lottery method. The maxillary and mandibular test sides were covered with periodontal dressing for 07 days, later the dressing was detached. After 12 weeks, all clinical parameters were recorded again by the same examiner. Results: Mean age was found to be 45.28 years in males and 41.27 years in females. The mean Kappa value of intra-examiner reliability was identified as 0.95. In comparison to control group, test group showed a highly significant improvement in all five tested periodontal variables when the values were compared at base line and then after 12 weeks. Conclusion: Periodontal dressing has significantly improved the clinical outcomes and the periodontal parameters after Scaling and Root Planning procedures.