Repair of Accidentally Perforated Labial Wall of a Central Incisor Having Failed Root Treatment -A Case Report

Abstract This is a successfully managed clinical case report of a young lady whose tooth # 11 was root treated in 2010 which reinfected after three years. The root treatment was repeated but was iatrogenically perforated because of the operating dentist's error. The tooth was therefore opened for surgical correction. During the procedure, it was found that labial wall of the tooth was missing in the mid-root area. The labial wall was built using glass ionomer cement keeping the endodontic file in the canal to avoid obliteration of canal space by glass ionomer. The rebuilt canal was treated with Calcium Hydroxide dressings at an interval of 7 days. In two weeks as the sinus healed, swelling subsided and the canal became effortlessly dryable using just two absorbent points, the canal was obturated with a custom made gutta percha cone, employing glass ionomer as a canal sealer

Seroprevalence of Toxoplasma gondii Infection in Camels (Camelus dromedaries) in and around Bahawalpur Region of Pakistan

Toxoplasma gondii is an intracellular parasite, which infects human and animals by ingestion of tissue cyst, raw or undercooked meat or oocyst from soil, vegetables, fruits, water, soil and food contaminated by cat faeces or by transmission through the placenta, milk and blood transfusion. Seropositivity levels vary widely among different regions of the globe and according to sociocultural habits, geographic factors; climate and transmission routes and typically rise with age. In view of the worldwide importance of T. gondii, a study was conducted to determine the prevalence of T. gondii antibody in camels by using Toxoplasma Latex Test Kit. The overall prevalence of T. gondii infection in camels was recorded as 10%. Two camels were found seropositive at 1:16 dilution showing residual or nonspecific immunity, five camels were found seropositive at 1:128 showing acquired or evolving immunity, whereas three camels were positive at antibody titre of 1:256 giving an evidence of present infection. It was also noted that seropositivity of T. gondii in camels was higher in age group from 6–10 years; infection was higher in female camels having abortion history

Pediatric appendicitis score for identifying acute appendicitis in children presenting with acute abdominal pain to the emergency department

Objective: To determine the diagnostic accuracy of Pediatric Appendicitis Score (PAS) in predicting appendicitis in children presenting with acute abdominal pain to the Emergency Department (ED) of a private hospital in Pakistan. Methods: This validation study was through retrospective chart review of children between 4-18 years of age with clinical suspicion of acute appendicitis, presenting to the pediatric ED. Diagnostic accuracy was determined using sensitivity, specificity, predictive values, and area under the curve (AUC). Results: 104 children (76% boys) with mean (SD) age of 10.9 (3.5) years met the eligibility criteria. 91% (n=95) patients had moderate to high PAS (score ³4), and 95% (n=99) had biopsy-proven appendicitis. The likelihood ratio calculated for low, equivocal and high-risk PAS was 0.10, 2.17 and 2.53, respectively. An equivocal PAS (score 4-6) showed a sensitivity of 96.8%, specificity of 80%, positive predictive value of 98.9% and AUC of 0.84 for predicting acute appendicitis. Conclusion: PAS showed good diagnostic accuracy in predicting acute appendicitis in children presenting to the E

The biochemistry of ketogenesis and its role in weight management, neurological disease and oxidative stress

The section of mammalian metabolism known as ketogenesis is responsible for creating ketone bodies. In this mechanism, the liver responds to decreased glucose availability by producing the tiny, water-soluble molecules acetoacetate, D-3-hydroxybutyrate, and propanone. While ketone bodies are always present in small amounts in healthy people, dietary changes and some pathological circumstances can raise the concentrations of these substances in living organisms. The systemic effects of ketogenic diet (KD), despite its recent widespread usage, are poorly known and can range from potentially dangerous results to medically advantageous outcomes depending on the situation. Here, we discuss the metabolism and molecular signaling of ketone bodies before relating the biology of ketone bodies to debates about their potential or actual health benefits. According to the findings of this research, a KD can be used as a natural treatment for weight loss in fat individuals. This is a one-of-a-kind research that will follow the effects of a KD for 24 weeks. The patients' lipid, total cholesterol, LDL cholesterol, and glucose levels all decreased significantly, while their HDL cholesterol levels increased significantly. The adverse effects of medications widely used for weight loss in such individuals were not noted in patients on the KD.&nbsp

Prevalence of Multiplicity and Appropriate Adjustments Among Cardiovascular Randomized Clinical Trials Published in Major Medical Journals.

IMPORTANCE: Multiple analyses in a clinical trial can increase the probability of inaccurately concluding that there is a statistically significant treatment effect. However, to date, it is unknown how many randomized clinical trials (RCTs) perform adjustments for multiple comparisons, the lack of which could lead to erroneous findings. OBJECTIVES: To assess the prevalence of multiplicity and whether appropriate multiplicity adjustments were performed among cardiovascular RCTs published in 6 medical journals with a high impact factor. DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, cardiovascular RCTs were selected from all over the world, characterized as North America, Western Europe, multiregional, and rest of the world. Data were collected from past issues of 3 cardiovascular journals (Circulation, European Heart Journal, and Journal of the American College of Cardiology) and 3 general medicine journals (JAMA, The Lancet, and The New England Journal of Medicine) with high impact factors published between August 1, 2015, and July 31, 2018. Supplements and trial protocols of each of the included RCTs were also searched for multiplicity. Data were analyzed December 20 to 27, 2018. EXPOSURES: Data from the selected RCTs were extracted and verified independently by 2 researchers using a structured data instrument. In case of disagreement, a third reviewer helped to achieve consensus. An RCT was considered to have multiple treatment groups if it had more than 2 arms; multiple outcomes were defined as having more than 1 primary outcome, and multiple analyses were defined as analysis of the same outcome variable in multiple ways. Multiplicity was examined only for the analysis of the primary end point. MAIN OUTCOMES AND MEASURES: Outcomes of interest were percentages of primary analyses that performed multiplicity adjustment of primary end points. RESULTS: Of 511 cardiovascular RCTs included in this analysis, 300 (58.7%) had some form of multiplicity; of these 300, only 85 (28.3%) adjusted for multiplicity. Intervention type and funding source had no statistically significant association with the reporting of multiplicity risk adjustment. Trials that assessed mortality vs nonmortality outcomes were more likely to contain a multiplicity risk in their primary analysis (66.3% [177 of 267] vs 50.4% [123 of 244]; P < .001), and larger trials vs smaller trials were less likely to make any adjustments for multiplicity (35.6% [52 of 146] vs 21.4% [33 of 154]; P = .001). CONCLUSIONS AND RELEVANCE: Findings from this study suggest that cardiovascular RCTs published in medical journals with high impact factors demonstrate infrequent adjustments to correct for multiple comparisons in the primary end point. These parameters may be improved by more standardized reporting