Nevin Manimala

Acta Odontol Latinoam. 2021 Aug 1;34(2):149-155.

ABSTRACT

The aim of this study was to determine prevalence and describe the clinical and radiographic findings of three-rooted primary mandibular first and second molars in a Mexican population. Intraoral periapical radiograph, orthopantomogram or cone beam computed tomography (CBCT) were obtained. A total 2284 children from the state of Puebla, Mexico were examined, of whom 20 presented an anatomic variant in tooth crown shape. Of the total teeth with crown alterations, 10 first and 5 second primary mandibular molars were found to have supernumerary roots. In one case, it was possible to obtain micro-CT images. The study recorded prevalence, unilateral or bilateral occurrence, and ratio between sexes. Data were analyzed using descriptive statistics. Clinical findings were presence of an anatomical variation (tuberculum paramolare / right and/or left cervical convexity) in primary mandibular first molars. Second molars presented conventional crown morphology. Prevalence of three-rooted primary mandibular first and second molars was 0.44% and 0.22%, respectively. Male: female ratio for presence of threerooted primary mandibular first molars was 4:1, showing genetic predisposition in males, and for second molars it was 1.5:1, with no predisposition according to sex. The clinical and radiographic anatomical variants in primary molars should be considered by pediatric dentists during routine care because they may cause difficulties in restorations.

PMID:34570863

Acta Odontol Latinoam. 2021 Aug 1;34(2):143-148.

ABSTRACT

The aim of this study was to evaluate the amount of radiating energy transmitted through lithium disilicate discs of different thicknesses and opacities with different curing units (CU). Discshaped specimens 8 mm in diameter and 1.5 mm or 0.7 mm thick were designed with Zbrush® and Cura 3D® software, milled from HT and MO IPS e-maxCAD blocks (Ivoclar Vivadent) with Ceramill Mikro 4 (Amann Girrbach, Austria) and processed according to manufacturer instructions. Thickness was checked with a Mitutoyo (México) caliper. Four groups (n=4) were formed: G1(HT/1.5 mm), G2(MO/1.5 mm), G3(HT/0.7 mm) y G4(MO/0.7 mm), and the effect of three CUs: Coltolux (Coltene- Whaledent), LED.C, (Woodpecker Medical Instrument Co.Ltd) and Deepcure L(3M-ESPE) was tested Measurements were taken with a halogen and LED radiometer (Woodpecker® LM-1-Guilin Woodpecker Medical Instrument Co.Ltd) after applying the guide of each CU directly on the reading window (d) and after interposing each of the specimens. The ratio of transmitted energy was determined in each case and data was analyzed with repeated measures ANOVA and Tukey test for multiple comparisons. LED.C: d:1600 mW/cm2, G1: 0.31(0.00), G2: 0.14(0.00) G3: 0.54(0.01), G4: 0.38(0.01); Deepcure L: d:1500 mW/cm2, G1: 0.34(0.01), G2: 0.20(0,00), G3: 0.56(0.01), G4: 0.41(0.02); Coltolux: d:1275 mW/cm2, G1: 0.44(0.01), G2: 0.24(0,00), G3: 0.65(0.01), G4: 0.47(0,00). Statistically significant differences were found among the curing units (P<0.001) and for the interaction CU-thickness (P<0.001) and CU-opacity (P=0.023). Within the conditions of this study, the ratio of light transmitted through lithium disilicate structures is related to their thickness and opacity, and to the curing unit employed.

PMID:34570862

PLoS One. 2021 Sep 27;16(9):e0257653. doi: 10.1371/journal.pone.0257653. eCollection 2021.

ABSTRACT

The use of renal biopsy through laparoscopy is increasingly present both in human and veterinary medicine. However, both techniques require skill and training to make the operator capable to do it. The learning curve allows the quantitative and qualitative assessment of the number of attempts and minimum time for the surgical procedure. The objective included establish the learning curve for laparoscopy-guided kidney biopsy procedures in dog and pig corpses. Six dogs and six pigs corpses weighing less than 10 kg were used for this study. All corpses underwent kidney biopsy performed through laparoscopy. Twenty-four operators, two per animal, performed 20 renal biopsies each (10 for each kidney), with 480 collection-procedures in total. Duration and difficulty of the procedure and the biopsy sample quality were evaluated and statistical analysis was performed using a mixed regression model with a random effect of individuals and multivariate analysis of data. There were 91.5% of the samples that were adequate for evaluation. There was no significant difference in the number of glomeruli or cortex percentage considering the attempts in either species, demonstrating the operator’s ability since first collection. Swine samples showed higher amounts of renal cortex than canine samples. The procedure duration was shorter as more attempts were performed in dogs and pigs. From the fourth repetition, the professional reached a plateau for the variable related to ‘collection’, and from the second, the professional presented uniform duration for ‘sample storage’. Operators of the swine model acquired more agility than the dog ones. The variable ‘difficulty’ decreased as more repetitions were performed, reaching a plateau in the sixth attempt. Seven renal biopsies laparoscopy-guided are required for an operator to be considered ‘capable’ to perform the procedure in the referred species included. The learning curve for image-guided kidney biopsy procedures improves the implementation of this technique and benefits patients that undergo this procedure.

PMID:34570802 | DOI:10.1371/journal.pone.0257653

PLoS Negl Trop Dis. 2021 Sep 27;15(9):e0009679. doi: 10.1371/journal.pntd.0009679. eCollection 2021 Sep.

ABSTRACT

Dengue is recognized as a major health issue in large urban tropical cities but is also observed in rural areas. In these environments, physical characteristics of the landscape and sociodemographic factors may influence vector populations at small geographic scales, while prior immunity to the four dengue virus serotypes affects incidence. In 2019, a rural northwestern Ecuadorian community, only accessible by river, experienced a dengue outbreak. The village is 2-3 hours by boat away from the nearest population center and comprises both Afro-Ecuadorian and Indigenous Chachi households. We used multiple data streams to examine spatial risk factors associated with this outbreak, combining maps collected with an unmanned aerial vehicle (UAV), an entomological survey, a community census, and active surveillance of febrile cases. We mapped visible water containers seen in UAV images and calculated both the green-red vegetation index (GRVI) and household proximity to public spaces like schools and meeting areas. To identify risk factors for symptomatic dengue infection, we used mixed-effect logistic regression models to account for the clustering of symptomatic cases within households. We identified 55 dengue cases (9.5% of the population) from 37 households. Cases peaked in June and continued through October. Rural spatial organization helped to explain disease risk. Afro-Ecuadorian (versus Indigenous) households experience more symptomatic dengue (OR = 3.0, 95%CI: 1.3, 6.9). This association was explained by differences in vegetation (measured by GRVI) near the household (OR: 11.3 95% 0.38, 38.0) and proximity to the football field (OR: 13.9, 95% 4.0, 48.4). The integration of UAV mapping with other data streams adds to our understanding of these dynamics.

PMID:34570788 | DOI:10.1371/journal.pntd.0009679

PLoS One. 2021 Sep 27;16(9):e0257833. doi: 10.1371/journal.pone.0257833. eCollection 2021.

ABSTRACT

BACKGROUND: Compassion fatigue is associated with negative consequences that undermine workplace performance. However, literature is scarce on compassion fatigue among nurses in the context of Uganda who are at higher risk of compassion fatigue owed to the nature of their occupation and the unfavorable work environment. We aimed to assess the prevalence and predictors of compassion fatigue among nurses in Northern Uganda.

METHODS: We conducted a cross-sectional survey among 395 randomly selected nurses from two referral and four general hospitals in Northern Uganda. Data was collected using a self-administered questionnaire. Data analysis consisted of descriptive statistics, cross-tabulations, and logistic regression at a 95% level of significance in SPSS version 25.

RESULTS: Of 395 nurses who took part in the study, 58.2% were female, 39.8% had a diploma, 47.1% were single, and 32.4% had worked for between 11-15 years. Close to 50% of the nurses experienced compassion fatigue. The predictors of compassion fatigue among the participants were; workplace bullying (AOR: 3.83; 95% CI: 1.99-7.36; p = <0.001) career enhancement opportunities (AOR: 9.16; 95% CI: 2.32-36.22; p = 0.002; and remuneration (AOR: 7.30; 95% CI: 2.73-19.49; p = <0.001).

CONCLUSION: More than 3 in 4 nurses in Northern Uganda experience compassion fatigue. The Ministry of Health together with other stakeholders should strive to increase career enhancement opportunities for nurses, improve nurses’ remuneration and improve the overall workplace environment to prevent compassion fatigue among nurses in the country.

PMID:34570787 | DOI:10.1371/journal.pone.0257833

PLoS One. 2021 Sep 27;16(9):e0254141. doi: 10.1371/journal.pone.0254141. eCollection 2021.

ABSTRACT

BACKGROUND: In Mongolia, where there is a large regional gap in the quality of healthcare services, metabolic syndrome (MetS) is steadily increasing. However, there are few studies on the risk level of MetS and affecting factors among adults living in rural Mongolia. This study aims to explore the relationship between socio-demographics, clinical characteristics, emotional state, and social support on the risk level of MetS prevalence among adults living in rural Mongolia.

METHODS: In this cross-sectional study, 143 adults living in the soum area of Dondgovi aimag in Mongolia were recruited. Data collection was conducted from July 2 to 3, 2019. The self-reported questionnaires including socio-demographic, clinical characteristics and emotional status, anthropometric tests using the InBody, and blood sampling tests were conducted. The number of individual diagnostic criteria met was scored as a MetS risk score and classified into 6 groups, from the lowest score of 0 to the highest score of 5. The ordinal logistic regression analysis was used to identify the factors affecting the risk of MetS.

RESULTS: The prevalence of MetS among adults living in rural Mongolia was 58.0%, and the mean MetS risk score was 2.70±1.34 points. In the ordinal logistic regression analysis, age, regular exercise of moderate intensity or higher, InBody score reflecting obesity or sarcopenia, and depression level were statistically significantly associated with the risk score for MetS.

CONCLUSIONS: Our study demonstrated that MetS risk levels among adults living in rural Mongolia with limited medical resources were strongly associated with demographic characteristics, body composition and emotional health condition, particularly depression.

PMID:34570786 | DOI:10.1371/journal.pone.0254141

PLoS One. 2021 Sep 27;16(9):e0257267. doi: 10.1371/journal.pone.0257267. eCollection 2021.

ABSTRACT

BACKGROUND: The purpose of this study was to evaluate the analgesic effect of BMI1008 (a new drug containing lidocaine, methylene blue, dexamethasone and vitamin B complex) and to investigate the analgesic effect of lidocaine and BMI-L (other components of BMI1008 except lidocaine) at different concentrations in a rat model of incisional pain.

METHODS: Male Sprague-Dawley rats (250-300 g) were used for the incisional pain model simulating postoperative pain. After the operation, normal saline, various concentrations of BMI1008, lidocaine with a fixed concentration of BMI-L, and BMI-L with a fixed concentration of lidocaine were injected at the incision site. The preventive analgesic effect was evaluated using BMI1008 administered 30 min before and immediately after the operation. In addition, BMI1008 was compared with positive controls using intraperitoneal ketorolac 30 mg/kg and fentanyl 0.5 μg/kg. The mechanical withdrawal threshold was measured with a von Frey filament.

RESULTS: The analgesic effect according to the concentration of BMI1008, lidocaine with a fixed concentration of BMI-L, and BMI-L with a fixed concentration of lidocaine showed a concentration-dependent response and statistically significant difference among the groups (P <0.001, P <0.001, and P <0.001, respectively). The analgesic effect according to the time point of administration (before and after the operation) showed no evidence of a statistically significant difference between the groups (P = 0.170). Compared with the positive control groups, the results showed a statistically significant difference between the groups (P = 0.024).

CONCLUSION: BMI1008 showed its analgesic effect in a rat model of incisional pain in a concentration-dependent manner. Moreover, BMI-L showed an additive effect on the analgesic effect of lidocaine.

PMID:34570780 | DOI:10.1371/journal.pone.0257267

PLoS Comput Biol. 2021 Sep 27;17(9):e1009413. doi: 10.1371/journal.pcbi.1009413. Online ahead of print.

ABSTRACT

Persistent destruction of pancreatic β-cells in type 1 diabetes (T1D) results from multifaceted pancreatic cellular interactions in various phase progressions. Owing to the inherent heterogeneity of coupled nonlinear systems, computational modeling based on T1D etiology help achieve a systematic understanding of biological processes and T1D health outcomes. The main challenge is to design such a reliable framework to analyze the highly orchestrated biology of T1D based on the knowledge of cellular networks and biological parameters. We constructed a novel hybrid in-silico computational model to unravel T1D onset, progression, and prevention in a non-obese-diabetic mouse model. The computational approach that integrates mathematical modeling, agent-based modeling, and advanced statistical methods allows for modeling key biological parameters and time-dependent spatial networks of cell behaviors. By integrating interactions between multiple cell types, model results captured the individual-specific dynamics of T1D progression and were validated against experimental data for the number of infiltrating CD8+T-cells. Our simulation results uncovered the correlation between five auto-destructive mechanisms identifying a combination of potential therapeutic strategies: the average lifespan of cytotoxic CD8+T-cells in islets; the initial number of apoptotic β-cells; recruitment rate of dendritic-cells (DCs); binding sites on DCs for naïve CD8+T-cells; and time required for DCs movement. Results from therapy-directed simulations further suggest the efficacy of proposed therapeutic strategies depends upon the type and time of administering therapy interventions and the administered amount of therapeutic dose. Our findings show modeling immunogenicity that underlies autoimmune T1D and identifying autoantigens that serve as potential biomarkers are two pressing parameters to predict disease onset and progression.

PMID:34570760 | DOI:10.1371/journal.pcbi.1009413

Bol Med Hosp Infant Mex. 2021;78(5):385-394. doi: 10.24875/BMHIM.20000301.

ABSTRACT

BACKGROUND: Pulmonary involvement in juvenile systemic sclerosis (JSSc) is rare in children and contributes to morbimortality. This study aimed to describe the pulmonary function and clinical, radiologic, and tomographic findings in JSSc.

METHODS: Patients with JSSc between 5-14 years of age were included. Clinical, functional, and imaging characteristics were assessed. Patients were excluded if they showed lung disease not associated with JSSc: mixed connective tissue disease, overlap syndrome, or acute cardiopulmonary failure at the time of the study. All patients underwent physical examination, electrocardiogram, spirometry, chest X-ray, high-resolution computed tomography (HRCT) of the chest, echocardiography, lung function tests, and the 6-minute walk test (6-MWT). Descriptive statistics were employed for data analysis.

RESULTS: We studied 15 patients with the following characteristics: median age, 11 years; median since symptoms onset, 6 years; median since JSSc diagnosis and the finding of pulmonary involvement, 2 years. Lung disease was detected in 73%, interstitial lung disease (ILD) the most common affection (67%); pulmonary hypertension was found in 6.6%. 6-MWT was positive in 26.6%, forced vital capacity (FVC) was abnormal in 26.6%. No pulmonary involvement was found in four patients.

CONCLUSIONS: The most frequent pulmonary affection in JSSc was ILD. Thus, early JSSc detection and periodic lung monitoring are mandatory to avoid further complications once JSSc is diagnosed.

PMID:34570747 | DOI:10.24875/BMHIM.20000301

Dermatitis. 2021 Sep 27. doi: 10.1097/DER.0000000000000709. Online ahead of print.

ABSTRACT

BACKGROUND: Ethylhexylglycerin (EHG) is a recently recognized contact allergen.

OBJECTIVE: The aims of the study were to characterize individuals with positive patch test reactions to EHG and to analyze reaction strength, clinical relevance, and allergen sources.

METHODS: This study was a retrospective analysis of the patients patch tested to EHG (5% petrolatum) by the North American Contact Dermatitis Group (2013-2018).

RESULTS: Of 15,560 patients tested to EHG, 39 (0.25%) had positive (final interpretation of “allergic”) reactions. Most were female (71.8%) and/or older than 40 years (76.9%). There were no statistically significant differences between age, sex, or atopic history when compared with EHG-negative patients. The most common anatomic sites of dermatitis were the face (28.2%) and scattered generalized distribution (25.6%). Most EHG-positive reactions were + (35.9%) or ++ (33.3%). Current clinical relevance was high (79.5%); none, however, were related to occupation. Personal care products were the most common source of exposure to EHG (59.0%).

CONCLUSIONS: Ethylhexylglycerin is a rare contact allergen; the positive frequency of 0.25% is similar to other low allergenic preservatives including parabens, benzyl alcohol, and phenoxyethanol. The patch test concentration of 5.0% seems to be nonirritating. Although relatively uncommon, EHG reactions were usually clinically relevant (79.5%), often because of moisturizers/lotions/creams.

PMID:34570737 | DOI:10.1097/DER.0000000000000709