A Prospective Randomized Clinical Study of the Influence of Primary Closure or Dressing on Post‑operative Morbidity after Mandibular Third Molar Surgery

Objective: The aim of the following study is to determine the effect of primary closure or dressing on post‑operative morbidity after impacted lower third molar surgery. Materials and Methods: This was a randomized clinical study of 72 patients who had surgical extraction of impacted mandibular third molars. The subjects were divided into two groups of A and B. Group A had total closure (primary closure) and Group B had whitehead varnish dressing of the socket. Pain, swelling and trismus were evaluated pre‑operatively using visual analogue scale, flexible tape measuring method and inter‑incisal distance measurement with Vernier Callipers respectively as well as post‑operatively on 1st, 2nd, 3rd, 5th and 7th day. Results: The study participants consisted of 27 males and 45 females in a ratio 1:1.7. With a mean age of 24.7 ± 4.9 years (range 19‑33 years) for Group A and 25.5 ± 4.3 years (range 20‑39 years) for Group B. Post‑operative pain was not significantly affected by the closure techniques (P > 0.05). Dressing was found to significantly reduce the degree of swelling and trismus peaking on the 2nd day (P = 0.0207 and P = 0.010 respectively). Conclusion: The use of dressing was more effective than primary closure to reduce the degree of swelling and trismus though its effect on post‑operative pain reduction was not significant.Keywords: Dressing, primary closure, randomized, surgery, third molar

Autogenous Tooth Transplantation In Adult Orofacial Cleft Deformity: A Case Report

A case of autotransplantation of a tooth in a 26 year old female African cleft palate patient is reported. This case report emphasizes the possibility and success of autotransplantation in our centre, it also emphasizes that transplantation is only technique sensitive but less equipment sensitive. It further stresses that an otherwise extracted and discarded tooth can be used to make natural functional unit. Keyword: autotransplantation, tooth, cleft palate, success, technique sensitive, extraction

Analysis of greenhouse gas mitigation performance in UK urban areas

As the threat of irreversible climate change has increased over time, the UK has continued to set increasingly ambitious policies to reduce its carbon emission. An assessment of mitigation progress to date at the local authority level clarifies the factors that have affected greenhouse gas (GHG) emissions on the path to carbon neutrality. This research uses regression analyses between local authorities’ GHG emission redcutions and selected explanatory variables (including population density, household income, and manufacturing employment) identified from the literature to explore mitigation performance over time, focusing on GHG emissions changes between 2005 and 2016. Substantial and relatively consistent GHG emissions reductions were achieved in this time frame, with average total reductions across UK local authorities of 31.2%. Population density was moderately-to-strongly correlated with the success of transportation GHG emissions mitigation, though this sector has seen the smallest percentage declines over this period. Local authorities with densities below 25 inhabitants per hectare were generally among the poorest performers in transportation GHG mitigation. This underscores the need to support remote working and electrification of personal transportation in areas where public/active transportation options are not viable alternatives. Furthermore, consideration of population density in conjunction with domestic and urban planning will allow for future emissions reductions to occur across the UK. Fundamentally, GHG emissions reductions to date are largely driven by historic factors (density), shifting economic structures (deindustrialisation), and centralised initiatives (decarbonisation of electricity generation)

Three-dimensional digital reconstruction of human placental villus architecture in normal and complicated pregnancies.

Objective: This study aimed to examine the use of digital technology in the three-dimensional reconstruction of human placentas. Study design: Placentas obtained at term elective caesarean section were sampled, formalin-fixed and embedded in paraffin. Two hundred 5 mm consecutive sections were cut from each specimen and the resultant slides stained with haematoxylin and eosin. Slides were then scanned and the digitised images reconstructed using customised software. Results: Three-dimensional reconstructions were successfully achieved in placentas from normal pregnancies and those complicated by pre-eclampsia, growth restriction, and gestational diabetes. Marked morphological differences were readily identifiable, most clearly in the stem villus architecture. Conclusion: This method is an emerging research tool for examining placental histoarchitecture at high resolution and gaining clinically relevant insight into the placental pathology allied to pregnancy complications such as PET, IUGR and GD

Microbiomics in collusion with the nervous system in carcinogenesis : diagnosis, pathogenesis and treatment

The influence of the naturally occurring population of microbes on various human diseases has been a topic of much recent interest. Not surprisingly, continuously growing attention is devoted to the existence of a gut brain axis, where the microbiota present in the gut can affect the nervous system through the release of metabolites, stimulation of the immune system, changing the permeability of the blood–brain barrier or activating the vagus nerves. Many of the methods that stimulate the nervous system can also lead to the development of cancer by manipulating pathways associated with the hallmarks of cancer. Moreover, neurogenesis or the creation of new nervous tissue, is associated with the development and progression of cancer in a similar manner as the blood and lymphatic systems. Finally, microbes can secrete neurotransmitters, which can stimulate cancer growth and development. In this review we discuss the latest evidence that support the importance of microbiota and peripheral nerves in cancer development and dissemination.The South African Medical Research Council (SAMRC).https://www.mdpi.com/journal/microorganismsam2022Surger

HUS and atypical HUS

Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy characterized by intravascular hemolysis, thrombocytopenia, and acute kidney failure. HUS is usually categorized as typical, caused by Shiga toxin-producing Escherichia coli (STEC) infection, as atypical HUS (aHUS), usually caused by uncontrolled complement activation, or as secondary HUS with a coexisting disease. In recent years, a general understanding of the pathogenetic mechanisms driving HUS has increased. Typical HUS (ie, STEC-HUS) follows a gastrointestinal infection with STEC, whereas aHUS is associated primarily with mutations or autoantibodies leading to dysregulated complement activation. Among the 30% to 50% of patients with HUS who have no detectable complement defect, some have either impaired diacylglycerol kinase epsilon (DGK epsilon) activity, cobalamin C deficiency, or plasminogen deficiency. Some have secondary HUS with a coexisting disease or trigger such as autoimmunity, transplantation, cancer, infection, certain cytotoxic drugs, or pregnancy. The common pathogenetic features in STEC-HUS, aHUS, and secondary HUS are simultaneous damage to endothelial cells, intravascular hemolysis, and activation of platelets leading to a procoagulative state, formation of microthrombi, and tissue damage. In this review, the differences and similarities in the pathogenesis of STEC-HUS, aHUS, and secondaryHUSare discussed. Commonfor the pathogenesis seems to be the vicious cycle of complement activation, endothelial cell damage, platelet activation, and thrombosis. This process can be stopped by therapeutic complement inhibition in most patients with aHUS, but usually not those with a DGK epsilon mutation, and some patients with STEC-HUS or secondary HUS. Therefore, understanding the pathogenesis of the different forms of HUS may prove helpful in clinical practice.Peer reviewe

Stereological investigation of placental villous and vascular morphology in pre-eclampsia with and without intrauterine growth restriction

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A Reader Response Inquiry Into Gender Semiosi in Selected Plays of Tess Onwueme

ABSTRACT All literary theories seek answers to key questions as to what literariness entails, who a writer writes for and what determines meaning in a text: the writer the text or the reader. While not totally neglecting form, modern literary theories tend towards recognizing literature's communicative function to the extent that readers are considered important in literary creation and reception. In line with this, this study has attempted to situate the reader at the center of literary creation while at the same time recognizing the role of the text form in the interpretive process. Four of Tess Onwueme's gender plays: A Hen Too Soon, The Broke Calabash,The Reign of Wazobiaand Then.She Said It were subjected to gender semiosis using the framework of Roland Barthes orders of signification The formed feature of the plays selected for analysis was the proairetic code - one of Barthes five connotative codes. The analysis revealed deep-rooted gender connotations in the actions of the characters. Reader responses to these codes were sought empirically usmq questionnaires, structured interviews and focus group discussions. It was hypothesized that there would be no significant differences between male and female readers at the levels of recognition of codes, appreciation of their gender content, pleasure and empathy with the female protagonist(s). There were significant differences at the level of empathy in The Broken calabash and The Reign of Wazobia Also in Then She Said It there was a significant difference at the level of recoqnitr.n of codes. The actions of the characters as coded in the proairetic codes in all the plays selected therefore 'portrayed gender connotations, wi Itch were recoqnized, not only by the researcher but also by actual readers of the plays. New insights gained from the readers' input to the analys: s include the fact that some qender semiotised codes were considered to be devoid of gender implications by the readers - especially the male readers. The fact that female readers empathized more with the female protagonists than the male readers also shows that they identified more with the gender issues raised in the plays, being thernserves part of a socio-political system that marginalizes women. On the other hand, the low level of empathy by the males is a clear index of g'3nder indifference on their part. This attitude is reflective of the continued marginalization of women by a malo dominated society under the pretext that ti ie women do not have anything to complain about. The use of real readers as opposed to hypothetical ones has further proved the efficacy of Empirical studies in Literature (ESL) as a tool ill literacy enterprise. The role of the reader as demonstrated in this work, confirms the reader- response paradigm that literary success presumes a book that expresses the expectation of an interpretive community.Literatur

An Evaluation of the Quality of Consent Taking for Elective Maxillofacial Surgical Cases in a Tertiary Hospital.

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