Reasons for seeking orthodontic treatment in Lahore population: A cross-sectional survey in a low-income country

ABSTRACT Introduction: Poor esthetics, dysfunction and discomfort are the key reasons for seeking orthodontic treatment across the world as reported by many researchers. This paper presents the causative factor for seeking orthodontic treatment in the patients who are visiting Punjab Dental Hospital of a populous city Lahore (de\u27 Montmorency College of Dentistry) in local settings and associating these reasons with demographic characteristics. Objective: Aim of this cross-sectional survey was to explore the reasons for seeking orthodontic treatment among individuals who are visiting PDH. Materials and methods: This study was carried out in Punjab Dental Hospital (PDH) after the approval of the Institutional Review Board (IRB) on a sample of 98 individuals having malocclusion assessed with Angle\u27s classification of the malocclusion. We chose simple random sampling. A self-structure questionnaire was designed to get data by the principal investigator after taking verbal and written consent. Descriptive statistics were calculated using SPSS 21. Chi-square test of association was applied to associate reasons with different demographic variables. P-value <0.05 was taken as significant. Results: Female respondents were more in number than males. Around one-third of respondents (30.6 %) had a monthly income of less than 25000 PKR ($ 170). Esthetics was the primary reason for seeking orthodontic treatment. The most common type of malocclusion was the Class II malocclusion. Statistically significant factors that emerged in this study that turned into reasons for seeking orthodontic treatment were hurdles in marriage, referral by a general dentist, motivation by parents, self-esteem and speech problems. Conclusion: In conclusion, patients seek orthodontic treatment mainly to enhance facial esthetics and self-confidence, motivation by the parents, and social acceptability

The Role of Lead Toxicity on Eruption Rate of Hypofunctional Incisors in Albino Wistar Rats

OBJECTIVES This objective of this study was to evaluate the role of a heavy metal- lead acetate in the eruption rate of hypo functional incisors in albino Wistar rats. METHODOLOGY An experimental study was done in animal house of Post Graduate Medical Institute, Lahore since March 2019 to March 2020. 34 adult albino Wistar rats were randomly divided into two groups (n=17 for each group) i.e., control and lead acetate group. Right mandibular incisors were selected for this study. Selected incisors were marked 1mm above the level of gingival papillae. The incisors were cut above this mark to make it hypo-functional. The readings were measured by digital Vernier caliper. This was considered as day 0. Incisors length was measured at day 0, 3, 6, 12 and 15 and eruption was calculated. The data was analyzed using SPSS version 22. RESULTS Eruption rate was similar throughout the study except last follow up. At the end of this study eruption of incisors in albino Wistar rats in control was 03.30±0.72mm, in lead 02.43±1.19mm. At day 15, the difference between control and lead group was statistically significant (p-value 0.033). CONCLUSION These results reveal that besides other causes of delayed tooth eruption excessive lead intoxication are also acausative factor of delayed tooth eruption

Generation of miniploid cells and improved natural transformation procedure for a model cyanobacterium Synechococcus elongatus PCC 7942

The biotechnologically important and naturally transformable cyanobacterium, Synechococcus elongatus PCC 7942, possesses multiple genome copies irrespective of its growth rate or condition. Hence, segregating mutations across all genome copies typically takes several weeks. In this study, Synechococcus 7942 cultivation on a solid growth medium was optimised using different concentrations of agar, the addition of antioxidants, and overexpression of the catalase gene to facilitate the rapid acquisition of colonies and fully segregated lines. Synechococcus 7942 was grown at different temperatures and nutritional conditions. The miniploid cells were identified using flow cytometry and fluorimetry. The natural transformation was carried out using miniploid cells and validated with PCR and high performance liquid chromatography (HPLC). We identified that 0.35% agar concentration and 200 IU of catalase could improve the growth of Synechococcus 7942 on a solid growth medium. Furthermore, overexpression of a catalase gene enhanced the growth rate and supported diluted culture to grow on a solid medium. Our results reveal that high temperature and phosphate-depleted cells contain the lowest genome copies (2.4 ± 0.3 and 1.9 ± 0.2) and showed the potential to rapidly produce fully segregated mutants. In addition, higher antibiotic concentrations improve the selection of homozygous transformants while maintaining similar genome copies at a constant temperature. Based on our observation, we have an improved cultivation and natural transformation protocol for Synechococcus 7942 by optimising solid media culturing, generating low-ploidy cells that ultimately reduced the time required for the complete segregation of engineered lines

What constitutes responsiveness of physicians: A qualitative study in rural Bangladesh

Responsiveness entails the social actions by health providers to meet the legitimate expectations of patients. It plays a critical role in ensuring continuity and effectiveness of care within people centered health systems. Given the lack of contextualized research on responsiveness, we qualitatively explored the perceptions of outpatient users and providers regarding what constitute responsiveness in rural Bangladesh. An exploratory study was undertaken in Chuadanga, a southwestern Bangladeshi District, involving in-depth interviews of physicians (n = 17) and users (n = 7), focus group discussions with users (n = 4), and observations of patient provider interactions (three weeks). Analysis was guided by a conceptual framework of responsiveness, which includes friendliness, respecting, informing and guiding, gaining trust and optimizing benefits. In terms of friendliness, patients expected physicians to greet them before starting consultations; even though physicians considered this unusual. Patients also expected physicians to hold social talks during consultations, which was uncommon. With regards to respect patients expected physicians to refrain from disrespecting them in various ways; but also by showing respect explicitly. Patients also had expectations related to informing and guiding: they desired explanation on at least the diagnosis, seriousness of illness, treatment and preventive steps. In gaining trust, patients expected that physicians would refrain from illegal or unethical activities related to patients, e.g., demanding money against free services, bringing patients in own private clinics by brokers (dalals), colluding with diagnostic centers, accepting gifts from pharmaceutical representatives. In terms of optimizing benefits: patients expected that physicians should be financially sensitive and consider individual need of patients. There were multiple dimensions of responsiveness- for some, stakeholders had a consensus; context was an important factor to understand them. This being an exploratory study, further research is recommended to validate the nuances of the findings. It can be a guideline for responsiveness practices, and a tipping point for future research

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Mitotic Index and Immunohistochemical Expression of Ki-67 in Pleomorphic Adenoma of Salivary Glands

. Background: Pleomorphic adenomas (PAs) are the most common type of salivary gland tumors (SGTs) which may undergo malignant transformation to Carcinoma ex PA (CaExPA). The purpose of this study was to determine mitotic index (MI) and expression of Ki-67 in Pleomorphic adenomas of salivary gland tumors. Methodology: This study was carried out on sixty patients of pleomorphic adenoma. Slides with specimens were stained with Hematoxylin &amp; Eosin to count Mitotic index. Labeling Index (LI) of Ki-67 was determined immunohistochemically. Mitotic figures (MF) were counted in 10 HPF selected in the proliferative area. MI was scored as 1 (0 to 4 MF per 10 HPF); 2 (5-9 MF per 10 HPF) and 3 (&gt; 9 MF per 10 HPF). Immunoexpression of Ki-67 was scored as ‘0-negative’ when &lt;5% of neoplastic cells stained, ‘1-weak positive’ when 5-19% of neoplastic cells were stained, ‘2-moderate positive’ when 20-49% of neoplastic cells were stained, and ‘3-strong positive’ when &gt;50% of neoplastic cells were stained with Ki-67. Data was, entered in SPSS 21. Results: Mean age was 38.7 ± 12.86 years. Out of 60 cases, 26 (43.33%) were of males while 34 (56.67%) were of females. Expression of Ki-67 was negative in 50% while remaining weak positive. Only score 01 of MI observed. Conclusion:&nbsp; Ki-67 is more sensitive marker than mitotic index in pleomorphic adenomas even in small sized tumors and it can help in detection of malignant transformation of PAs. Keywords: Adenomas, Immunohistochemistry, Ki-67 Antigen, Parotid Neoplasms, Pleomorphi

Immunohistochemical Expression of BCL-2 in Malignant Salivary Gland Tumors

Background: Malignant salivary gland tumors (MSGTs) consist of a heterogeneous group of neoplasms with complex clinicopathological features and biological behaviors. The purpose of this study was to determine the expression of Bcl-2 antiapoptotic protein in mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ADCC), acinic cell carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA) of salivary glands and to find out its association with different grades of these tumors. Material and Methods: This descriptive study included 55 cases of MSGTs. Tissue sections were stained with routine hematoxylin and eosin stain as well as Bcl-2 immunostain. MSGTs were graded as low grade (Low grade MEC, ACC, PLGA, and tubular pattern of ADCC), intermediate grade (cribriform pattern of ADCC, and intermediate grade of MEC) and high grade (high grade of MEC and solid pattern of ADCC) tumors on H&amp;E sections. Bcl-2 expression was scored as ‘negative’ (&lt;5% of neoplastic cells), ‘1’ (5-19% of neoplastic cells), ‘2’ (20-49% of neoplastic cells), and ‘3’ (&gt;50% of neoplastic cells), respectively. Results: MSGTs most commonly involved the parotid gland (52.7%), while ADCC (40%) and MEC (38.2%) were the most common tumors. Expression of Bcl-2 was strongly positive in 56.4% cases of MSGTs which included ADCC (71%), MEC (19.4%) and ACC (9.7%), respectively. A significant association was found between Bcl-2 staining and types of MSGTs i.e., MEC, ADCC, ACC (P = .001) as well as between Bcl-2 staining and grades of MSGTs (P = .013). Conclusions: Bcl-2 protein is expressed in malignant salivary gland tumors. Its expression maybe helpful in grading small biopsies, predicting behavior, and planning targeted therapy of MSGTs. &nbsp; &nbsp

Clinicopathological Features and Expression of Ki-67 in Odontogenic Keratocyst, Dentigerous Cyst and Radicular Cyst

Background: Biological behaviour of Odontogenic Keratocyst (OKC) is aggressiveness than others Odontogenic Cysts (OCs) like Dentigerous Cyst (DCs) and Periapical Cyst/Residual Cysts (RCs). The aim of the study was to determine clinicopathological features and expression of Ki-67 in Odontogenic Cysts of the oral cavity. Methodology: This cross-sectional study was conducted at de’Montmorency College of Dentistry (DCD from Feb, 2020 to Feb, 2022 after approval from Institutional Review Board (IRB) of DCD. A total 78 cases of OCs were collected from hospitals which are affiliated with the DCD. Routine lab process for Hematoxylin &amp; Eosin and Immunohistochemistry was performed. Data entry and statistical analysis was carried out in SPSS 21. A Chi- square test was applied to observe the association between cyst and Ki-67. P value &lt; 0.05 was taken as statistically significant.&nbsp;&nbsp;&nbsp;&nbsp; Results: Among total 78 cases the mean age was 25.08 ±14.5 years with an age range of 6-70 years. Most OCs (64.1%) were reported in males than females (35.89%). Most OCs were reported in mandible (56.4%. Ki-67 expression in OKC was high 7.7%, low in 76.9% and negative in 15.4%). Most of the DCs and RCs expressed low expression of Ki-67 (84.6% and 76.9% respectively). &nbsp; Conclusion: Most of the odontogenic cysts expressed low expression of Ki-67 while few cases of OKC and DC expressed high expression. Keywords: Dentigerous Cyst, Odontogenic Keratocyst, Immunohistochemistry, Ki-67, Odontogenic Cysts, Periapical Cyst, Radicular Cyst

Discovery of Five New Ethylene-Forming Enzymes for Clean Production of Ethylene in E. coli

Ethylene is an essential platform chemical with a conjugated double bond, which can produce many secondary chemical products through copolymerisation. At present, ethylene production is mainly from petroleum fractionation and cracking, which are unsustainable in the long term, and harmful to our environment. Therefore, a hot research field is seeking a cleaner method for ethylene production. Based on the model ethylene-forming enzyme (Efe) AAD16440.1 (6vp4.1.A) from Pseudomonas syringae pv. phaseolicol, we evaluated five putative Efe protein sequences using the data derived from phylogenetic analyses and the conservation of their catalytic structures. Then, pBAD expression frameworks were constructed, and relevant enzymes were expressed in E. coli BL21. Finally, enzymatic activity in vitro and in vivo was detected to demonstrate their catalytic activity. Our results show that the activity in vitro measured by the conversion of &alpha;-ketoglutarate was from 0.21&ndash;0.72 &mu;mol ethylene/mg/min, which varied across the temperatures. In cells, the activity of the new Efes was 12.28&ndash;147.43 &mu;mol/gDCW/h (DCW, dry cellular weight). Both results prove that all the five putative Efes could produce ethylene

Exploring the Synergistic Anticancer Potential of Benzofuran&ndash;Oxadiazoles and Triazoles: Improved Ultrasound- and Microwave-Assisted Synthesis, Molecular Docking, Hemolytic, Thrombolytic and Anticancer Evaluation of Furan-Based Molecules

Ultrasound- and microwave-assisted green synthetic strategies were applied to furnish benzofuran&ndash;oxadiazole 5a&ndash;g and benzofuran&ndash;triazole 7a&ndash;h derivatives in good to excellent yields (60&ndash;96%), in comparison with conventional methods (36&ndash;80% yield). These synthesized derivatives were screened for hemolysis, thrombolysis and anticancer therapeutic potential against an A549 lung cancer cell line using an MTT assay. Derivatives 7b (0.1%) and 5e (0.5%) showed the least toxicity against RBCs. Hybrid 7f showed excellent thrombolysis activity (61.4%) when compared against reference ABTS. The highest anticancer activity was displayed by the 5d structural hybridwith cell viability 27.49 &plusmn; 1.90 and IC50 6.3 &plusmn; 0.7 &mu;M values, which were considerably lower than the reference drug crizotinib (IC50 8.54 &plusmn; 0.84 &mu;M). Conformational analysis revealed the spatial arrangement of compound 5d, which demonstrated its significant potency in comparison with crizotinib; therefore, scaffold 5d would be a promising anticancer agent on the basis of cytotoxicity studies, as well as in silico modeling studies