Experience with NESTROFT for screening for thalassemia trait/ minor: evaluation against CBC and HPLC in a high prevalence region in Saurashtra, Gujarat, India

Background: Hemoglobinopathies pose a significant health burden in India. Prevention programmes can significantly reduce this burden. Although sophisticated methods of screening for β thalassemia trait are available, a cheap and simple method is beneficial for population screening. Although the Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) has been evaluated in many studies, sample sizes were small in some and many earlier studies have not done complete blood count (CBC) and High-Performance Liquid Chromatography (HPLC) in all the cases. We evaluate the suitability of NESTROFT for detection of β-thalassemia trait in a high prevalence region in Saurashtra, Gujarat.Methods: Here, 1000 unrelated individuals were studied. NESTROFT, CBC and estimation of HbA2 and HbF or other hemoglobin variants were done by HPLC.Results: Prevalence of β thalassemia trait was 7.8% in this population. NESTROFT showed an overall sensitivity and specificity of 94.87 and 85.38 respectively for the detection of β thalassaemia trait. Using red cell indices (MCH <27 pg and MCV <80 fl), One β thalassemia trait with normal indices would have been missed. Among twelve individuals with other hemoglobinopathies (HbS, HbD, HbE, δβ thalassemia trait or HPFH), seven had a positive NESTROFT while three had normal MCV & MCH values.Conclusions: NESTROFT is a cost-effective sensitive test which does not require any equipment and can be done in remote areas. It remains a useful first line screening test when large populations have to be screened.

Canal transportation and centering ability of HyFlex CM and TruNatomy rotary file systems in moderately curved root canals using CBCT: An in vitro study

Aim: The objective of this study was to evaluate and compare canal transportation (CT) and centering ability (CA) in the curved canals prepared using HyFlex CM (HCM) and TruNatomy (TN) rotary file systems with the help of cone-beam computed tomography (CBCT). Materials and Methods: Forty extracted single-rooted mandibular premolars with 10°–30° of curvature were selected and divided into two groups. In Group 1, the canals were prepared with HCM files (Coltene Whaledent) and in Group 2 the canals were prepared with TN Prime rotary files (Dentsply Sirona). Pre- and postinstrumentation scans were performed at the same position using CBCT to evaluate CT and CA at three levels 3 mm, 6 mm, and 9 mm from the apex and were compared using CBCT software (On Demand 3D software). Statistical Analysis Used: The two groups were statistically analyzed with Mann–Whitney U-test. Results: There was no significant difference among the tested groups regarding the canal centering ratio (P > 0.05). At 6- and 9-mm levels, there was no significant difference in CT among the two groups (P > 0.05). However, at 3 mm from apex, there was a statistically significant difference (P = 0.006) with TN files exhibiting lesser CT. Conclusion: Both the file systems respected the canal anatomy, although in the apical third, TN files exhibited better results. Hence, this file system can be considered for instrumentation of canals with moderate apical curvatures. In regard to CA, no significant differences were found among the file systems