Evaluation of Records of Oral and Maxillofacial Surgery Cases Reported at Abbasi Shaheed Hospital and Karachi Medical and Dental College, Pakistan

Background: Oral and Maxillofacial Surgery department is a diverse field in dentistry. Record maintenance has been established as one of the key factors in the success and integrity of health care institutes.Objective: The objective of the study was to evaluate the records of oral and maxillofacial surgery casesreported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD ofKarachi Medical and Dental College.Methods: Cross sectional study was conducted in at ASH and KMDC from July 2019 to September 2019.The data from January 2017 to July 2019 was retrospectively noted through electronic surgical recordof ASH and records of the Oral Surgery OPD of KMDC. Inclusion criteria was patients records of bothgenders of 5–70 years age, having complaint of any oral or dental pathology or pathologies, trauma andimpactions. Data was calculated manually by calculating frequencies and percentages for the trauma,impaction and pathology cases of patients.Results: In 2017, 239 cases were treated under general anesthesia from which trauma 11. 45% (n=11),followed by 48. 11% (n=115) cases of oral pathologies, total 11.7% (n=28) cases of complicated exodontias. In2018, among 211, 51.1% (n=108) cases were trauma followed by 39.3% (n=83) cases of oral pathologies,whereas, total 9.4% (n=20) complicated exodontias cases were observed. During 2019 (January to July),168 cases 36.2% (n=62) cases were diagnosed as trauma, in oral pathology, overall 36.2% (n=62) caseswere surgically excised. Total 23.2% (n=39) complicated exodontias. In 2017, 25122 cases were reported in Surgery OPD of Karachi Medical and Dental College. Total 36.2% (n=9097) teeth were extracted from which 1.93% (n=486) cases were surgical impaction. On the other hand, 1.65% (n=416) patients were treated through minor oral surgeries. In 2018, 29008 cases were reported in Surgery OPD. Total 42.7% (n=12377) teeth were extracted from which 0.92% (n=268) cases were surgical impaction. On the other hand, 0.71% (n=208) patients were treated through minor surgeries. In 2019, January till July 13028 cases were reported in Surgery OPD. Total42.6% (n=5559) teeth were extracted from which 0.66% (n=87) cases were surgical impaction. On the other hand, 0.68% (n=89) patients were treated through minor surgeries.Conclusion: It has been concluded that evaluation of the records of oral and maxillofacial surgery casesreported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD ofKarachi Medical and Dental College were high and appropriate measures should be taken in order tomanage these problems timely and effectively

Frequency and associated factors for anxiety and depression in pregnant women: a hospital-based cross-sectional study.

Antepartum anxiety and/or depression is a major public health problem globally. The aim of this study was to estimate the frequency of antepartum anxiety and/or depression among pregnant women. This was a cross-sectional study conducted in a tertiary care hospital among pregnant women. A total of 165 pregnant women were interviewed by a clinical psychologist using HADS for assessing anxiety and/or depression and also collected information regarding sociodemographic, obstetric, family relationships, and home environment. Out of the total of 165 pregnant women about 70 percent of them were either anxious and/or depressed. The increasing age of women (P-value = 0.073), not having any live birth (P-value = 0.036), adverse pregnancy outcome in past including death of a child, stillbirth or abortion (P-value = 0.013), participant\u27s role in household decision making (P-value = 0.013), and domestic violence (verbal or physical abuse towards mother or children by any family member) (P-value = 0.123). Our study highlights that anxiety and/or depression is quite common among pregnant women. Therefore, there is a need to incorporate screening for anxiety and depression in the existing antenatal programs and development of strategies to provide practical support to those identified

Environmental enteropathy in undernourished Pakistani children: Clinical and histomorphometric analyses

Despite nutrition interventions, stunting thought to be secondary to underlying environmental enteropathy (EE) remains pervasive among infants residing in resource-poor countries and remains poorly characterized. From a birth cohort of 380 children, 65 malnourished infants received 12 weeks of nutritional supplementation with ready-to-use therapeutic food (RUTF). Eleven children with insufficient response to RUTF underwent upper endoscopy with duodenal biopsies, which were compared with U.S., age-matched specimens for healthy, celiac disease, non-celiac villous atrophy, non-celiac intraepithelial lymphocytosis, and graft-versus-host disease patients. Of the 11 children biopsied, EE was found in 10 (91%) with one subject with celiac disease. Morphometry demonstrated decreased villus-to-crypt (V:C) ratios in EE relative to healthy and non-celiac lymphocytosis patients. Environmental enteropathy villus volumes were significantly decreased relative to healthy controls. In EE, average CD3+ cells per 100 epithelial cells and per 1,000 µm2 of lamina propria and the number of lamina propria CD20+ B-cell aggregates were increased relative to all other groups. Our results indicate that V:C ratios are reduced in EE but are less severe than in celiac disease. Environmental enteropathy intraepithelial and lamina propria T lymphocytosis is of greater magnitude than that in celiac disease. The increases in lamina propria B and T lymphocytes suggest that non-cytolytic lymphocytic activation may be a more prominent feature of EE relative to celiac disease. These results provide new insights into shared yet distinct histological and immunological features of EE and celiac disease in children

The study of removal chromium (VI) ions from aqueous solution by bimetallic ZnO/FeO nanocomposite with Siltstone: Isotherm, kinetics and reusability

In this study, nanocomposites of Baghanwala Siltstone (BSS) with ZnO (BSS/ZnO), FeO (BSS/FeO), and BSS/ZnO/FeO were successfully prepared for the removal of hexavalent chromium [(Cr (VI)] from aqueous solutions via a batch adsorption process. The characterization studies by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX) found successful synthesis of the composites and demonstrated the occurrence of different active functional groups that played an active role in Cr ion adsorption. The effect of Cr initial concentrations (25–100 mg/L), adsorbent dose (0.5–2 g/L), pH (2–8), and contact time (0–160 min) on Cr remediation from contaminated water was examined. The order of Cr ion removal was BSS/ZnO/FeO (77–87%) \u3e BSS/ZnO (74–83%) \u3e BSS/FeO (71–77%) \u3e BSS (68–74%). The as-synthesized BSS/ZnO/FeO led to successful Cr removal (87%) at a 25 mg/L Cr concentration at pH 4.0. The Cr ion adsorption by the BSS/ZnO/FeO nanocomposite was well explained by the Langmuir adsorption isotherm model (R2 \u3e 0.99), while the kinetic experimental data was well fitted with the pseudo-second-order model (R2 \u3e 0.99). Among the as-synthesized adsorbents, the BSS/ZnO/FeO nanocomposite showed excellent stability and reusability in seven sorption cycles. The results showed that the as-synthesized BSS/ZnO/FeO nanocomposite had the greatest adsorption potential for removing Cr ions from contaminated water

TNN-IDS: Transformer neural network-based intrusion detection system for MQTT-enabled IoT Networks

The Internet of Things (IoT) is a global network that connects a large number of smart devices. MQTT is a de facto standard, lightweight, and reliable protocol for machine-to-machine communication, widely adopted in IoT networks. Various smart devices within these networks are employed to handle sensitive information. However, the scale and openness of IoT networks make them highly vulnerable to security breaches and attacks, such as eavesdropping, weak authentication, and malicious payloads. Hence, there is a need for advanced machine learning (ML) and deep learning (DL)-based intrusion detection systems (IDS). Existing ML-based IoT-IDSs face several limitations in effectively detecting malicious activities, mainly due to imbalanced training data. To address this, this study introduces a transformer neural network-based intrusion detection system (TNN-IDS) specifically designed for MQTT-enabled IoT networks. The proposed approach aims to enhance the detection of malicious activities within these networks. The TNN-IDS leverages the parallel processing capability of the Transformer Neural Network, which accelerates the learning process and results in improved detection of malicious attacks. To evaluate the performance of the proposed system, it was compared with various IDSs based on ML and DL approaches. The experimental results demonstrate that the proposed TNN-IDS outperforms other systems in terms of detecting malicious activity. The TNN-IDS achieved optimum accuracies reaching 99.9% in detecting malicious activities

Serum anti-flagellin and anti-lipopolysaccharide immunoglobulins as predictors of linear growth faltering in Pakistani infants at risk for environmental enteric dysfunction

Background: Environmental Enteric Dysfunction (EED) in children from low-income countries has been linked to linear growth declines. There is a critical need to identify sensitive and early EED biomarkers.Objective: Determine whether levels of antibodies against bacterial components flagellin (flic) and lipopolysaccharide (LPS) predict poor growth.Design/Methods: In a prospective birth cohort of 380 children in rural Pakistan blood and stool samples were obtained at ages 6 and 9 months. Linear mixed effects models were used to examine longitudinal associations between quartiles of anti-flic and anti-LPS antibodies and changes in LAZ, WAZ and WLZ scores. Spearman\u27s correlations were measured between anti-flic and anti-LPS immunoglobulins with measures of systemic/enteric inflammation and intestinal regeneration.Results: Anti-LPS IgA correlated significantly with CRP, AGP and Reg1 serum at 6mo and with MPO at 9mo. In multivariate analysis at 6mo of age, higher anti-LPS IgA levels predicted greater declines in LAZ scores over subsequent 18mo (comparing highest to lowest quartile, β (SE) change in LAZ score/year = -0.313 (0.125), p-value = 0.013). Anti-flic Ig A in the two highest quartiles measured at 9mo of age had declines in LAZ of -0.269 (0.126), p = 0.033; and -0.306 (0.129), p = 0.018 respectively, during the subsequent 18mo of life, compared to those in the lowest quartile of anti-flic IgA.Conclusions and Relevance: Elevated anti-flic IgA and anti-LPS IgA antibodies at 6 and 9mo, predict declines in linear growth. Systemic and enteric inflammation correlated with anti-LPS IgA provides mechanistic considerations for potential future interventions

Tackling antimicrobial resistance in primary care facilities across Pakistan : current challenges and implications for the future

Antibiotics are gradually becoming less effective against bacteria worldwide, and this issue is of particular concern in economically-developing nations like Pakistan. We undertook a scoping review in order to review the literature on antimicrobial use, prescribing, dispensing and the challenges associated with antimicrobial resistance in primary care (PC) settings in Pakistan. Furthermore, this review aims to identify potential solutions to promote appropriate use of antimicrobials in Pakistan. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist, a comprehensive scoping review was conducted to review the literature of antimicrobials used, prescribed and dispensed in PC settings in Pakistan. Google Scholar and Pub-Med were searched for the period 2000–2023. Papers were analyzed on the basis of eligibility i.e., included antimicrobial use, prescribing and dispensing practices by general population at homes, by prescribers in outpatient departments of hospitals and by pharmacists/dispensers in community pharmacies, respectively. Two researchers analyzed the articles thoroughly and disagreements were resolved through discussion with a third reviewer. Both quantitative and qualitative research studies were eligible for inclusion. Additionally, the selected papers were grouped into different themes. We identified 4070 papers out of which 46 studies satisfied our eligibility criteria. The findings revealed limited understanding of antimicrobial resistance (AMR) by physicians and community pharmacists along with inappropriate practices in prescribing and dispensing antibiotics. Moreover, a notable prevalence of self-medication with antibiotics was observed among the general population, underscoring a lack of awareness and knowledge concerning proper antibiotic usage. Given the clinical and public health implications of AMR, Pakistan must prioritize its policies in PC settings. Healthcare professionals (HCPs) need to reduce inappropriate antibiotic prescribing and dispensing, improve their understanding of the AWaRe (access, watch and reserve antibiotics) classification and guidance, monitor current usage and resistance trends, as well as implement antimicrobial stewardship (ASP) activities starting in targeted locations

Peroxiredoxin 6 in human brain: molecular forms, cellular distribution and association with Alzheimer’s disease pathology

Peroxiredoxin 6 is an antioxidant enzyme and is the 1-cys member of the peroxiredoxin family. Using two-dimensional electrophoresis and Western blotting, we have shown for the first time that, in human control and brain tissue of patient’s with Alzheimer’s disease (AD), this enzyme exists as three major and five minor forms with pIs from 5.3 to 6.1. Using specific cellular markers, we have shown that peroxiredoxin 6 is present in astrocytes with very low levels in neurons, but not detectable in microglia or oligodendrocytes. In control brains, there was a very low level of peroxiredoxin 6 staining in astrocytes that was confined to a “halo” around the nucleus. In AD, there were marked increases in the number and staining intensity of peroxiredoxin 6 positive astrocytes in both gray and white matter in the midfrontal cortex, cingulate, hippocampus and amygdala. Confocal microscopy using antibodies to Aβ peptide, tau and peroxiredoxin 6 showed that peroxiredoxin 6 positive astrocytes are closely involved with diffuse plaques and to a lesser extent with neuritic plaques, suggesting that plaques are producing reactive oxygen species. There appeared to be little astrocytic response to tau containing neurons. Although peroxiredoxin 6 positive astrocytes were seen to make multiple contacts with tau positive neurons, there was no intraneuronal colocalization. In brain tissue of patients with AD, many blood vessels exhibited peroxiredoxin 6 staining that appeared to be due to the astrocytic foot processes. These results suggest that oxidative stress conditions exist in AD and that peroxiredoxin 6 is an important antioxidant enzyme in human brain defenses