Nevin Manimala

BMC Oral Health. 2023 Feb 25;23(1):127. doi: 10.1186/s12903-023-02832-3.

ABSTRACT

OBJECTIVE: This systematic review (SR) with meta-analysis aimed to evaluate the frequency of micronuclei in the oral mucosa exfoliated cells after cone-beam computed tomography (CBCT) examination.

METHODS: We performed language-independent computer-assisted data searches using PubMed databases, Cochrane, Embase, Web of Science all databases, and Google Scholar. The literature on micronucleus (MN) frequency of clinical trials before and after CBCT examination was included. The frequency of MN in exfoliated cells of the human oral mucosa was the primary outcome of the study. All statistical analyses were performed with R (version 4.1.0), RStudio (version 2022.02.2 + 485) software, and Meta packages (version 5.2-0). Two reviewers independently assessed the quality of the included studies by the EPHPP (Effective Public Health Practice Project) Modified scale with minor modifications. The heterogeneity of the data was analyzed using I² statistics, in which I² > 50% was considered substantial heterogeneity.

RESULTS: A total of 559 articles were selected through the search strategy. After screening titles and abstracts, nine full-text manuscripts were assessed for eligibility, and six observational studies were included in the meta-analysis. The present study showed a significant increase in MN frequency of human oral mucosal exfoliated cells 10 days after CBCT examination compared to baseline (SMD = – 0.56, 95%-CI = – 0.99 ~ – 0.13, p = 0.01). Because of the high heterogeneity among the studies (I² = 72%), after removing one study that was the main source of heterogeneity, excluding the study (I² = 47%), the common-effect model was chosen, and the meta-analysis also showed that the frequency of MN in human oral mucosa exfoliated cells increased significantly 10 days after CBCT examination (SMD = – 0.35, 95%-CI = – 0.59 ~ – 0.11, p = 0.004).

CONCLUSION: This review suggested that CBCT examination increases the frequency of micronuclei in oral mucosal exfoliated cells.

PMID:36841769 | DOI:10.1186/s12903-023-02832-3

BMC Oral Health. 2023 Feb 25;23(1):126. doi: 10.1186/s12903-023-02831-4.

ABSTRACT

BACKGROUND: A novel injectable mixture termed treated dentin matrix hydrogel (TDMH) has been introduced for restoring dentin defect in DPC. However, no study evaluated its physiological biodegradation. Therefore, the present study aimed to assess scaffold homogeneity, mechanical properties and biodegradability in vitro and in vivo and the regenerated dentin induced by TDMH as a novel pulp capping agent in human permanent teeth.

METHODS: Three TDMH discs were weighted, and dry/wet ratios were calculated in four slices from each disc to evaluate homogeneity. Hydrogel discs were also analyzed in triplicate to measure the compressive strength using a universal testing machine. The in vitro degradation behavior of hydrogel in PBS at 37 °C for 2 months was also investigated by monitoring the percent weight change. Moreover, 20 intact fully erupted premolars were included for assessment of TDMH in vivo biodegradation when used as a novel injectable pulp capping agent. The capped teeth were divided into four equal groups according to extraction interval after 2-, 8-, 12- and 16-weeks, stained with hematoxylin-eosin for histological and histomorphometric evaluation. Statistical analysis was performed using F test (ANOVA) and post hoc test (p = 0.05).

RESULTS: No statistical differences among hydrogel slices were detected with (p = 0.192) according to homogeneity. TDMH compression modulus was (30.45 ± 1.11 kPa). Hydrogel retained its shape well up to 4 weeks and after 8 weeks completely degraded. Histological analysis after 16 weeks showed a significant reduction in TDMH area and a simultaneous significant increase in the new dentin area. The mean values of TDMH were 58.8% ± 5.9 and 9.8% ± 3.3 at 2 and 16 weeks, while the new dentin occupied 9.5% ± 2.8 at 2 weeks and 82.9% ± 3.8 at 16 weeks.

CONCLUSIONS: TDMH was homogenous and exhibited significant stability and almost completely recovered after excessive compression. TDMH generally maintained their bulk geometry throughout 7 weeks. The in vivo response to TDMH was characterized by extensive degradation of the hydrogel and dentin matrix particles and abundant formation of new dentin. The degradation rate of TDMH matched the rate of new dentin formation.

TRIAL REGISTRATION: PACTR201901866476410: 30/1/2019.

PMID:36841767 | DOI:10.1186/s12903-023-02831-4

Br J Nurs. 2023 Feb 23;32(4):S22-S28. doi: 10.12968/bjon.2023.32.4.S22.

ABSTRACT

Rates of obesity in pregnant women are increasing. Obesity is linked to increased patient risk of developing postoperative wound complications such as surgical site infection, wound dehiscence and haematoma formation. Closed incision negative pressure wound therapy (ciNPWT) has been introduced as a prophylactic intervention to reduce caesarian section (C-section) wound complications. Evidence from randomised controlled trials and retrospective studies has shown variable rates of success in reducing risk of SSI. The studies reviewed in this article found that ciNPWT had no statistically significant impact in reducing rates of wound dehiscence and haematoma formation or increasing long-term satisfaction with the appearance of scar tissue following C-section. Further research into the use of cINPWT to prevent surgical site infection is needed to determine the effectiveness of this therapy in reducing this wound complication.

PMID:36840522 | DOI:10.12968/bjon.2023.32.4.S22

Urol J. 2023 Jan 1. doi: 10.22037/uj.v20i.7359. Online ahead of print.

ABSTRACT

PURPOSE: To compare the risk of complications between laparoscopic peritoneal dialysis (PD) catheter placement and open PD catheter placement.

METHODS: We searched numerous databases, including SinoMed, CNKI, cqVIP, WanFang, Pubmed, Web of Science, OVID, Cochrane and Scopus, for published randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) .

RESULTS: Ten studies were included(n=1341). The overall statistical results showed that patients receiving laparoscopic insertion of the PD catheter had a lower risk of catheter migration, inadequate drainage and blockage. The risk of leakage was higher in the laparoscopic group in studies performed prior to 2015; in studies performed after 2015, the risk of leakage was lower than in the conventional open-placement group. For the risk of developing pain, the risk was lower in the subgroup of laparoscopic patients starting PD within 1 day after catheter insertion; however, there was no significant difference between the subgroups starting PD 1 week or 2 weeks after catheter insertion. The risk outcome for abdominal bleeding was similar to that for pain, with a lower risk in the subgroup of laparoscopic patients starting PD within 1 day. The overall research quality was moderate.

CONCLUSION: Laparoscopic placement of the PD catheter has unique advantages over conventional open surgical placement, especially in special conditions such as emergency initiation. In addition, we found that some factors that were previously considered irrelevant may have an impact on the results for Asians. However, this conclusion still needs to be substantiated by further large samples in multicenter, high quality Randomized Controlled Trials (RCTs).

PMID:36840476 | DOI:10.22037/uj.v20i.7359

Inquiry. 2023 Jan-Dec;60:469580231153268. doi: 10.1177/00469580231153268.

ABSTRACT

The first year after a woman has given birth is critical for use of contraceptives although many women do not realize that they are at a risk for pregnancy. The main objective of this study was to assess the utilization of modern Postpartum Family Planning (PPFP) and associated factors among postpartum women in a rural district, Ethiopia. A cross-sectional study involving randomly selected 389 postpartum women was conducted in Ambo rural district from May 20, 2021 to June 10, 2021. Data were collected through face to- face interviews, entered into EPI Data version 3.1, and analyzed by SPSS version 25.0. In multivariable binary logistic regression, adjusted odds ratios (AOR) with 95% confidence interval (CI) were computed and statistical significance was declared at p < 0.05. The prevalence of modern PPFP was 72.5% (95% CI: 68%, 77%). Utilization of PPFP was significantly associated with women’s self decision making (AOR = 6.43, 95% CI: 1.98, 20.90), counseling during antenatal care (AOR = 9.71, 95% CI: 3.83, 24.61), visit health facility after delivery (AOR = 5.24, 95% CI: 2.32, 11.84), ever heard of modern family planning (AOR = 5.17, 95% CI: 1.88, 14.23), perceived partner approval (AOR = 4.31, 95% CI: 1.62, 11.47), and the lowest income (AOR = 0.12, 95% CI: 0.02, 0.68). The use of modern PPFP in the study area was encouraging, which helps to prevent unplanned and unwanted pregnancies and spacing pregnancies. Therefore, family planning providers should focus on raising women’s awareness and counseling their partners as part of a continuum of points of contact to encourage women to use the service.

PMID:36840470 | DOI:10.1177/00469580231153268

Urol J. 2023 Feb 25. doi: 10.22037/uj.v20i.7465. Online ahead of print.

ABSTRACT

PURPOSE: To describe the feasibility of computed tomography (CT)-ultrasound image fusion technique on guiding percutaneous kidney access in vitro and vivo.

MATERIALS AND METHODS: we compare CT-ultrasound image fusion technique and ultrasound for percutaneous kidney puncture guidance by using an in vitro pig kidney model. The fusion method, fusion time, ultrasound screening time, and success rate of puncture were compared between the groups. Next, patients with kidney stones in our hospital were randomized in the study of simulated puncture guidance. The general condition of patients, fusion method, fusion time, and ultrasound screening time were compared between the groups.

RESULTS: A total of 45 pig models were established, including 23 in CT-ultrasound group and 22 in ultrasound group. The ultrasound screening time in CT-ultrasound group was significantly shorter than that in ultrasound group (P < .001). In addition, the success rate of puncture in CT-ultrasound group was significantly higher than that in ultrasound group (P =.015). Furthermore, in simulated PCNL puncture study, baseline data including age, BMI, and S.T.O.N.E score between the two groups showed no statistical difference. The ultrasound screening time of the two groups was (2.60 ± 0.33) min and (3.37 ± 0.51) min respectively, and the difference was statistically significant (P < .001).

CONCLUSION: Our research revealed that CT-ultrasound image fusion technique was a feasible and safe method to guide PCNL puncture. Compared with traditional ultrasound guidance, CT-ultrasound image fusion technique can shorten the learning curve of PCNL puncture, improve the success rate of puncture, and shorten the ultrasound screening time.

PMID:36840447 | DOI:10.22037/uj.v20i.7465

Urol J. 2023 Feb 25. doi: 10.22037/uj.v20i.7412. Online ahead of print.

ABSTRACT

PURPOSE: Recent studies have provided reliable evidence for a relationship between loss of PTEN gene expression and prognosis in patients suffering from prostate cancer, although the results have been somewhat diverse in different populations. We aimed to assess PTEN gene expression loss by immunohistochemistry in prostate cancer and also its link to tumor upgrading in a group of affected patients undergoing radical prostatectomy.

MATERIALS AND METHODS: This cross-sectional study was performed on 58 tissue samples sourced from the patients with prostate cancer and undergoing radical prostatectomy. TRUS-guided needle biopsies of the cancer tissue samples with histological grade groups of I to IV (the Gleason scores of 6 to 8) were prepared as the study samples. 29 patients with Gleason score (6 to 8) whose tumors on needle biopsy upgraded to Gleason score 7, 8 or 9 at prostatectomy (cases) were compared with 29 patients with Gleason scores of 6, 7 or 8 on both biopsy and prostatectomy samples (controls). Immunohistochemistry (IHC) technique was employed to determine PTEN gene expression status. Results: Loss of PTEN gene expression was found in 62.1% of upgraded cases compared with 27.6% of controls, indicating a statistically significant difference, revealing a meaningful association between the loss of PTEN gene expression and tumor upgrading. Furthermore, we demonstrated that deletions of PTEN gene expression and increased Gleason score in control and upgraded case groups, did not reach statistical significance.

CONCLUSION: A high rate of PTEN gene expression loss can be detected in prostate cancer tumor tissue, and this loss of gene expression is associated with tumor upgrading.

PMID:36840446 | DOI:10.22037/uj.v20i.7412

Orthod Craniofac Res. 2023 Feb 24. doi: 10.1111/ocr.12643. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to evaluate the bond strengths of two different composite types used in the production of clear aligner attachments on monolithic zirconia with three different surface roughening processes.

MATERIALS AND METHODS: Packable composite Filtek Z250 was used in one group (PC-G) and flowable composite Filtek Supreme Ultra Flowable was used in the other group (FC-G). PC-G and FC-G groups were also divided into three subgroups as diamond bur+silane (Group 1), 50 μm aluminum oxide (Al₂ O₃ ) sandblasting+silane (Group 2) and 110 μm Al₂ O₃ sandblasting+silane (Group 3). Scanning electron microscopy (SEM) analysis was performed. Clear aligner attachments were bonded to the monolithic zirconia specimens. Shear bond strength (SBS) values were measured. Statistical analysis was performed using two-way ANOVA and post-hoc Tukey’s tests (p < .05).

RESULTS: The highest SBS value was found in PC-G sandblasted with 110 μm (p ≤ .001). The etching method with 110 μm sandblasting showed high SBS values in both composite types. The lowest SBS value gave FC-G in diamond bur roughening (p ≤ .001).

CONCLUSIONS: For the bonding of clear aligner attachments on monolithic zirconia, roughening with 110 μm particle size sandblasting and the choice of packable composite could be recommended in terms of retention.

PMID:36840412 | DOI:10.1111/ocr.12643

J Magn Reson Imaging. 2023 Feb 24. doi: 10.1002/jmri.28631. Online ahead of print.

ABSTRACT

BACKGROUND: While graph measures are used increasingly to characterize human connectomes, uncertainty remains in how to use these metrics in a quantitative and reproducible manner. Specifically, there is a lack of community consensus regarding the number of streamlines needed to generate connectomes.

PURPOSE: The purpose was to define the relationship between streamline count and graph-measure value, reproducibility, and repeatability.

STUDY TYPE: Retrospective analysis of previously prospective study.

POPULATION: Ten healthy subjects, 70% female, aged 25.3 ± 5.9 years.

FIELD STRENGTH/SEQUENCE: A 3-T, T1-weighted sequences and diffusion-weighted imaging (DWI) with two gradient strengths (b-values = 1200 and 3000 sec/mm² , echo time [TE] = 68 msec, repetition time [TR] = 5.4 seconds, 120 slices, field of view = 188 mm² ).

ASSESSMENT: A total of 13 graph-theory measures were derived for each subject by generating probabilistic whole-brain tractography from DWI and mapping the structural connectivity to connectomes. The streamline count invariance from changes in mean, repeatability, and reproducibility were derived.

STATISTICAL TESTS: Paired t-test with P value <0.05 was used to compare graph-measure means with a reference, intraclass correlation coefficient (ICC) to measure repeatability, and concordance correlation coefficient (CCC) to measure reproducibility.

RESULTS: Modularity and global efficiency converged to their reference mean with ICC > 0.90 and CCC > 0.99. Edge count, small-worldness, randomness, and average betweenness centrality converged to the reference mean, with ICC > 0.90 and CCC > 0.95. Assortativity and average participation coefficient converged with ICC > 0.75 and CCC > 0.90. Density, average node strength, average node degree, characteristic path length, average local efficiency, and average clustering coefficient did not converge, though had ICC > 0.90 and CCC > 0.99. For these measures, alternate definitions that converge a reference mean are provided.

DATA CONCLUSION: Modularity and global efficiency are streamline count invariant for greater than 6 million and 100,000 streamlines, respectively. Density, average node strength, average node degree, characteristic path length, average local efficiency, and average clustering coefficient were strongly dependent on streamline count.

EVIDENCE LEVEL: 1.

TECHNICAL EFFICACY: Stage 1.

PMID:36840398 | DOI:10.1002/jmri.28631

Mol Genet Genomic Med. 2023 Feb 24:e2154. doi: 10.1002/mgg3.2154. Online ahead of print.

ABSTRACT

BACKGROUND: Congenital myasthenic syndromes (CMSs) are characterized by hypotonia, episodic apnea, muscle weakness, ptosis and generalized fatigability. CMS type 20 (CMS20) is a rare disorder caused by variants in SLC5A7. In contrast to most other CMSs, CMS20 is also associated with neurodevelopmental disorders (NDDs). Only 19 patients from 14 families have been reported so far.

METHODS: We studied a 12-year-old boy with symptoms manifested at six weeks of age. Later, he also showed speech delay, moderate intellectual disability and autism. Analysis of CMS genes known at the time of clinical diagnosis yielded no results. Trio exome sequencing (ES) was performed.

RESULTS: ES revealed compound heterozygosity for two SLC5A7 variants, p.(Asn431Lys) and p.(Ile291Thr). While the first variant was absent from all databases, the second variant has already been described in one patient. In silico analysis of known pathogenic SLC5A7 variants showed that variants with a higher predicted deleteriousness may be associated with earlier onset and increased severity of neuromuscular manifestations.

CONCLUSION: Our patient confirms that CMS20 can be associated with NDDs. The study illustrates the strength of ES in deciphering the genetic basis of rare diseases, contributes to characterization of CMS20 and suggests trends in genotype-phenotype correlation in CMS20.

PMID:36840359 | DOI:10.1002/mgg3.2154