Assessing water contamination with anionic surfactants in Anzall Lagoon

We assessed amount of surfactants and their seasonal trend in eight stations in Anzali Lagoon and compared them with allowable levels in the years 2001 2002. We obtained 96 water samples and determined their surfactant content using liquid - liquid method applying methylene blue active substance (MBAS). The concentration of surfactants in Pirbazar varied from 0.176 to 0.422 while that of the Sea station was somewhere between 0.098 to 0.049 mg/i. Seasonal concentration of surfactants varied from 0.049 to 0.422 mgil averaging on 0.137 mg/1. A significant difference was found for surfactant concentration in different parts of the lagoon (p<0.05) with the eastern zone being the most polluted area with 0.422 g/l of the pollutants compared to 0.066 mg/1 in the Sea. The highest amount of the surfactants was seen in winter in contrast to the lowest amount in spring. No statistically significant difference was found between concentrations of the surfactants in different seasons

Prevalence and determinants of Otitis Media in children 1 to 6 years of age: An analytical cross-sectional study

Objectives: The aim of the present study was to determine the prevalence of Otitis Media; and to assess the risk factors for Otitis media in children aged one to six years of age. Methods: This was an analytical cross-sectional study conducted in the Rural Field Practice Area (RFPA) of a tertiary healthcare facility in north India between September 2018 and December 2019. Children in the age group of 1 to 6 years presenting with acute suppurative otitis media, or sequelae of acute otitis media including Otitis media with effusion and chronic otitis media were considered as cases of Otitis media. Results: The overall prevalence rate of Otitis media was found to be 12.7%. Regarding the distribution of types of Otitis media, it was found that 36.8% had Otitis media with effusion, 34.2% had eustachian tube catarrh, 21.1% had Chronic suppurative otitis media – Tubotympanic disease (CSOM-TTD), and 7.9% had Acute suppurative otitis media (ASOM), in that order. We found that age less than three years (or 36 months) (OR 2.86, 95% CI 1.92 to 3.45); living in a kutcha house (OR 1.91, 95% CI 1.04 to 3.74); malnutrition, that is weight for age <-2SD from reference median (OR 3.18, 95% CI 1.76 to 5.58); breastfeeding for less than six months (OR 2.24, 95% CI 1.30 to 4.88); and persistent rhinorrhoea (OR 2.78, 95% CI 1.56 to 4.33) were significant predictors of Otitis media among children one to six years of age (p<0.05). Conclusion: Efforts should focus on improving housing conditions, promoting breastfeeding practices, addressing malnutrition, and managing respiratory symptoms effectively

Cochlear implantation surgery in prelingually deaf children – Hearing and speech outcomes

Objectives: The objective of the present study was to assess the hearing and speech outcomes of prelingually deaf children who underwent cochlear implantation surgery in a tertiary healthcare facility; disaggregated by age and gender. Methods: This was an observational prospective study conducted in the Department of Paediatrics and Otorhinolaryngology of a tertiary healthcare facility in western India between June 2019 and May 2020. We enrolled all children between 1 and 6 years of age with bilaterally prelingual deafness (with no benefit using bearing aid) who underwent cochlear implantation surgery at the tertiary healthcare facility. Results: The results showed that the Categories of Auditory Performance (CAP) scale score (MD 1.52, 95% CI 1.24 to 1.80), Meaningful Auditory Integration Scale (MAIS) scores (MD 7.51, 95% CI 5.59 to 9.42), Speech Intelligibility Rating Scale (SIR) scores (MD 1.68, 95% CI 1.37 to 1.99), and Meaningful Use of Speech Scale (MUSS) scores (MD 9.02, 95% CI 7.59 to 10.45) significantly (p0.05). Conclusion: The findings indicate that younger children (1-3 years) tend to achieve better outcomes compared to older children (3-6 years) highlighting the importance of early cochlear implantation for optimizing auditory performance, better speech intelligibility and meaningful auditory integration in prelingually deaf children

Can hand dexterity predict the disability status of patients with multiple sclerosis?

Background: Multiple Sclerosis (MS) is the most common disabling neurological disease. Hand dysfunction is one of the main complaints of patients with MS. The present study aimed to compare hand dexterity of MS patients with low Expanded Disability Status Scale (EDSS) scores and healthy adults. It also sought to identify the predictors of disability status of patients with MS based on their manual dexterity and demographic characteristics. Methods: In this cross-sectional study, 60 (16 male/44 female) patients with MS and 60 (19 male/41 female) healthy people, who matched in terms of age and sex, were recruited. Their hand dexterity was evaluated by the Purdue Pegboard Test. The disability status of the MS group was determined by the Expanded Disability Status Scale. The data were analyzed using SPSS15. Results: The hand dexterity in MS group even with low EDSS score (1.5 ± 1.07) was weaker than control group. Moreover, the dexterity of dominant hand and alternating two hands coordination subtests of the PPT was a good discriminator between two groups (p<0.001). The results of linear regression analysis suggested dominant hand dexterity and disease duration as predictors of disability status that predict 60.5 per cent of the variation in EDSS scores in patients with MS (p<0.001). Conclusion: Reduced dominant hand dexterity in patients with MS is a disabling factor. Further research is recommended to determine if early hand rehabilitation can reduce the severity of disability in Patients with MS

Assessment of the relationship between iron overload based on cardiac t2* Mri and fragmented qrs in beta-thalassemia major patients

Background: Cardiac involvement in beta-thalassemia major patients is an important cause of mortality. Therefore, in these pa-tients, timely diagnosis of cardiac disorder is essential. Objectives: The present study aimed at determining the association between cardiac iron overload and fragmented QRS (fQRS). Methods: This cross-sectional study was conducted on 40 β-TM patients, aged 5-40 years. The presence of fQRS was evaluated in 12-lead surface electrocardiograms. Cardiac T2* MRI was performed to determine the iron overload. The patients were divided into four groups of chelation therapy. Results: The mean age of patients was reported to be 22.50 ± 6.75 years. The groups showed no significant difference regarding gender, age, or left ventricular ejection fraction. The presence of fQRS was detected in 10 patients (25), while T2* value was lower than 20 ms in 10 patients (25). The mean age of patients with and without fQRS was 26.23 ± 2.71 and 19.40 ± 2.61 years, respectively (P = 0.001). The univariate analysis indicated that fQRS had a significant relationship with cardiac iron overload (OR = 5; 95 CI: 1.04-23.99; P < 0.044). The multiple logistic regression analysis represented a significant association between iron overload and fQRS (OR = 5.556; 95 CI: 1.027-30.049). The sensitivity and specificity of the fQRS against MRI were equal to 50 and 83.3 respectively. Conclusions: The absence of fQRS on ECGs could be a good predictor of the lack of cardiac iron overload in β-TM patients. The results showed that fQRS might indicate the no need for close monitoring for cardiac overload with cardiac MRI and aggressive chelation therapy. © 2020, Author(s)

A review of pediatric femoral fracture patterns, surgical managements, and outcomes

Background: Femoral fractures are the most common pediatric orthopedic fractures that require hospitalization. The non-accidental injury should be suspected in early infancy and non-ambulatory children. Treatment of pediatric femoral fractures is widely variable and depends on intrinsic and extrinsic factors. This study presents pediatric femoral fracture epidemiology and outcomes and reviews the literature regarding best practices in pediatric femoral fractures.Methods: This retrospective study reviewed the clinical and radiological records of forty-sevens femur fractures in the pediatric age group from September 2020 until June 2021 in Prince Rashid bin AL Hassan Military Hospital in Jordan.Results: Males form 80.9% of patients. The mean age for the patients was equal to 6.70 years (±3.91). Falling is responsible for the majority of the injury. The middle femur shaft was fractured in 46.8%, and the pathological fracture was found in 17% of patients. Non-operative treatment by cast represents 42.6%. All fractures were healed at 7.90 weeks (±2.37).Conclusions: Pediatric femur fracture lacks standardized treatment. Nevertheless, most fractures healed with satisfactory results. Younger age groups are more likely to be treated non-operatively. Non-surgical treatment is more prone to shortening, angulation, and later return to weight-bearing and activity. Children older than eight years treated by plating demonstrated faster healing, return to full weight-bearing, and lower complication rate. 

SEM Analysis of MTAD Efficacy for Smear Layer Removal from Periodontally Affected Root Surfaces

Objective: Biopure® MTAD (Dentsply Tulsa Dental, USA) has been developedas a final irrigant following root canal shaping to remove intracanal smear layer.Many of the unique properties of MTAD potentially transfer to the conditioningprocess of tooth roots during periodontal therapy. The aim of this ex vivo studywas to evaluate the effect of MTAD on the removal of smear layer from root surfaces.Materials and Methods: Thirty two longitudinally sectioned specimens from 16freshly extracted teeth diagnosed with advanced periodontal disease were dividedinto four groups. In group 1 and 2, the root surfaces were scaled using Gracey curettes.In group 3 and 4, 0.5 mm of the root surface was removed using a fissurebur. The specimens in group 1 and 3 were then irrigated by normal saline. Thespecimens in groups 2 and 4 were irrigated with Biopure MTAD.All specimens were prepared for SEM and scored according to the presence ofsmear layer.Results: MTAD significantly increased (P=0.001) the smear layer removal inboth groups 2 and 4 compared to the associated control groups, in which only salinewas used.Conclusion: MTAD increased the removal of the smear layer from periodontallyaffected root surfaces. Use of MTAD as a periodontal conditioner may be suggeste

A comparison of validated methods used to assess impaired awareness of hypoglycaemia in type 1 diabetes: an observational study

Introduction Clarke, Gold and Pedersen are validated methods to assess awareness of hypoglycaemia. Identifying impaired awareness of hypoglycaemia (IAH) is critical for supporting people with structured education and diabetes technologies, to reduce harm of hypoglycaemia. This study compares the Clarke score, Gold score and Pedersen methods and their correlations with features of hypoglycaemia unawareness and patient characteristics, to evaluate the accuracy of the methods in identifying IAH. Methods This retrospective, observational questionnaire-based study collected routine clinical data from 100 people with type 1 diabetes. The questionnaire included the three validated scoring methods, frequency of severe and nocturnal hypoglycaemia, knowledge and worry of hypoglycaemia and hypoglycaemia symptom scores using the Edinburgh Hypoglycaemia Scale. Data were analysed for IAH prevalence and the associations with features of IAH. The concordance of Clarke, Gold and Pedersen methods was evaluated using Spearman’s correlation coefficient. Results The prevalence of IAH in this cohort identified by Clarke, Gold and Pedersen methods was 18%, 19% and 61% respectively. The mean autonomic symptom score in people with IAH was significantly reduced using the Clarke method (P = 0.0002) but not on Gold (P = 0.12) and Pedersen methods (P = 0.79). For people with IAH assessed using the Clarke method, scores for night-time worry regarding hypoglycaemia (P = 0.04) and self-reported frequency of nocturnal hypoglycaemia (P = 0.001) were increased. Spearman’s correlation coefficients between Pedersen and Clarke and Pedersen and Gold were Rs = 0.555 (P < 0.001) and Rs = 0.645 (P < 0.001) respectively. A moderate association was observed between Clarke and Gold Rs = 0.5669 (P < 0.001). Conclusion Whilst Clarke and Gold methods determined a similar prevalence of IAH, people identified with IAH assessed by the Clarke method had a significant association with the features and characteristics of IAH, including reduced autonomic symptoms. This study suggests that performing more than one score is important for a reliable risk assessment of IAH

Patient reported cosmetic outcome after vacuum assisted excision of benign breast lesions:a cross-sectional study

OBJECTIVE: Better cosmetic outcome after vacuum assisted excision (VAE) compared to surgical excision of benign breast lesions is suggested in previous studies but has never been evaluated with validated outcome measures. In this study, patient reported cosmetic outcome after VAE was evaluated. METHODS: Patients who underwent VAE between July 2017 and December 2018 were invited to complete the cosmetic subscale of the Dutch Breast Cancer Treatment Outcome Scale, comparing the treated with the untreated breast. Response mode ranged from 1 (no difference) to 4 (large difference) and cosmetic outcome was calculated as the unweighted mean. Clinical outcomes included: tumor size, number of cores, complications, residual lesions and recurrences. RESULTS: Response rate was 73.4% (47 of 64 patients). Median tumor size was 15 mm (range 5-51 mm) and median number of cores 6.5 (range 1-85), complete excision was confirmed in all but two patients. Mean cosmetic outcome was good (mean score ≤1.75) in 74% of patients and no patients reported a poor cosmetic outcome (mean score >3.25). A hematoma occurred in five patients (one needed aspiration) and a skin rash in one patient, no patients developed an infection or seroma. CONCLUSION: In this study VAE is safe and effective for tumors up to 5 cm and patient reported cosmetic outcome was good. Patients with benign lesions could benefit from VAE as an alternative for surgical excision. ADVANCES IN KNOWLEDGE: A formal quantitative measurement of cosmetic outcome after vacuum assisted excision for benign breast lesions was still lacking. This study shows that this cosmetic outcome is overall good in benign lesions up to 5 cm