Analysis of Nutritional Supplements and their Efficacy on Extraction Socket Healing in Patients Undergoing Orthodontic Extraction of Maxillary Premolar – A Split Mouth Study

Background Nutritional supplements have been known to play an effective role in wound healing. Lack of nutrition have been linked to a decline in wound tensile strength and increased infection rates. The present study aims to compare and evaluate the efficacy of nutritional supplements on the healing of the socket in patients undergoing bilateral maxillary first premolar extraction. Materials and Method This prospective split-mouth trial includes twenty patients undergoing orthodontic treatment and requiring bilateral maxillary first premolars extraction. They were split into two groups: \u27Group 14\u27 received only analgesics, while \u27Group 24\u27 received analgesics and additional supplements of multivitamins and minerals. Both the groups underwent extractions at the gap of one month in which ‘14’ was extracted prior to ‘24’ and socket dimensions, Buccolingual width (B), Mesiodistal width (M), and Depth (D) were measured on the day of extraction, day seven and day twenty-one to assess healing. Result In this study, 20 patients were split into \u27Group 14\u27 (no supplements) and \u27Group 24\u27 (with supplements). The patients, 10 males and 10 females had an average age of 18.20 ± 3.23 years. \u27Group 24\u27 had a slight reduction in M width on day seven and a slight reduction in B width on day twenty-one when compared to \u27Group 14’. However, no values were statistically significant. Conclusion The study shows that nutritional supplements led to slight socket healing improvement, but this wasn\u27t statistically significant. It recommends nutrient-rich diets for healing, alongside balanced nutrition, oral hygiene, and advice post-operative instructions

Identification of preexisting adaptive immunity to Cas9 proteins in humans

The CRISPR-Cas9 system is a powerful tool for genome editing, which allows the precise modification of specific DNA sequences. Many efforts are underway to use the CRISPR-Cas9 system to therapeutically correct human genetic diseases1-6. The most widely used orthologs of Cas9 are derived from Staphylococcus aureus and Streptococcus pyogenes5,7. Given that these two bacterial species infect the human population at high frequencies8,9, we hypothesized that humans may harbor preexisting adaptive immune responses to the Cas9 orthologs derived from these bacterial species, SaCas9 (S. aureus) and SpCas9 (S. pyogenes). By probing human serum for the presence of anti-Cas9 antibodies using an enzyme-linked immunosorbent assay, we detected antibodies against both SaCas9 and SpCas9 in 78% and 58% of donors, respectively. We also found anti-SaCas9 T cells in 78% and anti-SpCas9 T cells in 67% of donors, which demonstrates a high prevalence of antigen-specific T cells against both orthologs. We confirmed that these T cells were Cas9-specific by demonstrating a Cas9-specific cytokine response following isolation, expansion, and antigen restimulation. Together, these data demonstrate that there are preexisting humoral and cell-mediated adaptive immune responses to Cas9 in humans, a finding that should be taken into account as the CRISPR-Cas9 system moves toward clinical trials

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

A CROSS-SECTIONAL STUDY CONDUCTED FOR THE ASSESSMENT OF PREMENSTRUAL SYMPTOMS AMONG THE ADOLESCENT SCHOOL GIRLS OF MEHSANA CITY

Objectives: The ojective is to study menstrual patterns. To study the prevalence of pre-menstrual symptoms among high school girls. Methods: It is a cross-sectional, observational, and prospective study. A total of 384 adolescent girls were randomly enrolled in the study as per inclusion and exclusion criteria. Girls were belonging to higher secondary standards. Confidentiality was assured, and written informed consent was obtained. A data collection form was formed to conduct the survey. Ethical approval was obtained. The data were analyzed in MS Excel 2019. A descriptive analysis was done. Results: A total of 384 high school girls with an age of 15.65±1.16 years were enrolled in the study. The calculated mean body mass index (BMI) was 18.82±2.93. 40.4% had an underweight BMI. The majority of the adolescent girls had regular menstrual cycles, and a few had irregular menstrual cycles every month. More than half (60.41%) did not know about premenstrual syndrome. Physical premenstrual symptoms were a downward dragging sensation (58.78%), lower back pain (55.53%), acne flare-ups (44.63%), diffuse headaches (37.72%), and painful periods (33.88%). Psychological symptoms in hierarchy are anger or irritability (52.16%), less interest in usual activities (44.03%), pelvic cramping (45%), cravings for sweets (42.88%), and mood swings (41.53%). Conclusion: The prevalence of premenstrual symptoms was higher for physical and psychological symptoms. Physical symptoms can affect routine activities, and psychological symptoms affect girls’ behavior and mental status

Knowledge about COVID-19 and Practices among Hemodialysis Technicians in the COVID-19 Pandemic Era

INTRODUCTION: Hemodialysis technicians play a crucial role in infection control practices in hemodialysis units. Thus, it is important to assess the knowledge and attitude towards COVID-19 among hemodialysis technicians in this pandemic situation. MATERIALS AND METHODS: An online survey composed of 22 closed-ended questions using Google Forms was conducted in the month of April (13th to 19th) 2020. The survey consisted of questions regarding the knowledge of COVID-19 and current hemodialysis practice among hemodialysis technicians. The study was approved by the institutional ethics board. The survey was administered online through a mobile phone invitation. Basic statistics (mean and standard deviation or total number and percent) were computed for all covariates. RESULTS: Out of 150, 115 technicians participated in the survey. 80.9% of the participants were males. The mean age of respondents was 28.22 + 6.97 years. Most of the respondents could correctly identify fever (87.8%), breathlessness (86.08%), and dry cough (81.7%) as the symptoms of COVID-19 infection. 75.7% of the technicians were aware that it can be transmitted by asymptomatic persons. 61.1% of the technicians were segregating patients who had symptoms such as fever and cough to the last shift of the day. 81.1% of the technicians read the guidelines issued by the Indian Society of Nephrology—COVID-19 working group. But, only 25.5% of the respondents could rightly identify to keep a minimum distance of two meters between two beds while dialyzing a suspected patient of COVID-19 along with other patients to minimise risk of COVID-19 transmission. 60% of the technicians have received hydroxychloroquine as prophylaxis against coronavirus infection. CONCLUSION: Our study shows a significant knowledge gap among hemodialysis technicians about COVID-19. Effective COVID-19 education campaigns should be carried out intensively with relevant information among hemodialysis technicians to address the knowledge gap. A well-informed hemodialysis technician can prove to be a great tool to spread the right infection control practices among dialysis-dependent patients

Retroperitoneal paraganglioma in a patient with Fontan: The hypoxia connection

Paragangliomas are rare neuroendocrine tumors where hypoxia-inducible factor plays a critical role in tumorigenesis. It has been suggested that patients with congenital heart disease, in particular, may have cellular environment and relative hypoxia favorable to the development of these neuroendocrine tumors. Here, we present a case of an 11-year-old child with hypoplastic left heart syndrome previously palliated with Fontan procedure, diagnosed with paraganglioma on surveillance imaging. We present the clinical course, intervention, and outcome as well as review the possible contributory mechanisms. As we continue to improve long-term survival for single ventricle patients, awareness of these tumors during surveillance may be warranted as timely intervention may lead to cure

Postoperative Complications in Patients with Unrecognized Obesity Hypoventilation Syndrome Undergoing Elective Non-cardiac Surgery

BACKGROUND: Among patients with obstructive sleep apnea (OSA) a higher number of medical morbidities are known to be associated with those that have obesity hypoventilation syndrome (OHS) compared to OSA alone. OHS can therefore pose a higher risk of postoperative complications after elective non-cardiac surgery (NCS) and is often unrecognized at the time of surgery. The objective of this study was to retrospectively identify patients with OHS and compare their postoperative outcomes with those who have OSA alone. METHODS: Patients meeting criteria for OHS were identified within a large cohort of patients with OSA who underwent elective NCS at a major tertiary care center. We identified postoperative outcomes associated with OSA and OHS as well as the clinical determinants of OHS (BMI, AHI). Multivariable logistic or linear regression models were used for dichotomous or continuous outcomes, respectively. RESULTS: Patients with hypercapnia from definite or possible OHS, and overlap syndrome are more likely to develop postoperative respiratory failure [OR: 10.9 (95% CI 3.7-32.3), p<0.0001], postoperative heart failure (p<0.0001), prolonged intubation [OR: 5.4 (95% CI 1.9-15.7), p=0.002), postoperative ICU transfer (OR: 3.8 (95% CI 1.7-8.6), p=0.002]; longer ICU (beta coefficient: 0.86; SE: 0.32, p=0.009) and hospital length of stay (beta coefficient: 2.94; SE: 0.87, p=0.0008) when compared to patients with OSA. Among the clinical determinants of OHS, neither BMI nor AHI showed associations with any postoperative outcomes in univariable or multivariable regression. CONCLUSIONS: Better emphasis is needed on preoperative recognition of hypercapnia among patients with OSA or overlap syndrome undergoing elective NCSRevisión por pare

Miliary Tuberculosis with Hemophagocytosis in a Two Months Old Infant

A two months old male infant, presented with fever, hepatosplenomegaly and pancytopenia. On bone marrow aspirate, hemophagocytosis was noted. Trephine biopsy showed epithelioid granulomas. ZN stain AFB detected, which confirmed the diagnosis of miliary tuberculosis. This case highlights the rare association of hemophagocytic syndrome with tuberculosis in infancy