Comparison of soft tissue changes following orthodontic treatment with two different extraction patterns: Four first premolars vs. four second premolars

The purpose of this study was to compare the soft tissue changes in subjects with orthodontic treatment involving two different extraction patterns: four first premolars or four second premolars. Pretreatment and posttreatment orthodontic treatment records of 81 four premolar extraction patients were obtained and divided into two groups: (PM1) four first premolar extraction group (n= 48) and, (PM2) four second premolar extraction group (n=33). A comparison was made of the changes between the pre- and posttreatment measurements of nasolabial angle (NLA), upper and lower lips to E-plane(mm) using age, sex, upper lip thickness, convexity, and facial axis as variables. Correlation tests were also performed between changes in dental and soft tissue outcomes. The results showed that the NLA increased in both treatment groups indicating a reduction in soft tissue lip protrusion. However, there was no statistically significant difference between the two groups (p=0.99). The average change in lip position between the two groups was not statistically significantly different (p=0.68 and p=0.27 for the upper and lower lip to E-plane, respectively). The upper lip position was strongly correlated with the position of the upper incisor and the lower lip. Conclusion: There was no statistically significant difference between the change in the nasolabial angle or the retraction of the upper and lower lips between four first and four second premolar extraction orthodontic treatments. Furthermore, the change in the nasolabial angle was not significantly correlated with any dental or skeletal changes in either group. Clinically significant difference was found between the groups in some dental and soft tissue outcomes. Extraction pattern alone was not a significant predictor of the changes in soft tissues

Comparison of soft tissue changes following orthodontie treatment with two different extraction patterns: Four first premolars vs. four second premolars

The purpose of this study was to compare the soft tissue changes in subjects with orthodontie treatment involving two different extraction patterns: four first premolars or four second premolars. Pretreatment and posttreatment orthodontie treatment records of 81 four premolar extraction patients were obtained and divided into two groups: (PM1) four first premolar extraction group (n= 48) and, (PM2) four second premolar extraction group (n=33). A comparison was made of the changes between the pre- and posttreatment measurements of nasolabial angle (NLA), upper and lower lips to E-plane(mm) using age, sex, upper lip thickness, convexity, and facial axis as variables. Correlation tests were also performed between changes in dental and soft tissue outcomes. The results showed that the NLA increased in both treatment groups indicating a reduction in soft tissue lip protrusion. However, there was no statistically significant difference between the two groups (p=0.99). The average change in lip position between the two groups was not statistically significantly different (p=0.68 and p=0.27 for the upper and lower lip to E-plane, respectively). The upper lip position was strongly correlated with the position of the upper incisor and the lower lip. Conclusion: There was no statistically significant difference between the change in the nasolabial angle or the retraction of the upper and lower lips between four first and four second premolar extraction orthodontie treatments. Furthermore, the change in the nasolabial angle was not significantly correlated with any dental or skeletal changes in either group. Clinically significant difference was found between the groups in some dental and soft tissue outcomes. Extraction pattern alone was not a significant predictor of the changes in soft tissues

Biotechnological applications of polymeric nanofiber platforms loaded with diverse bioactive materials

This review article highlights the critical research and formative works relating to nanofiber composites loaded with bioactive materials for diverse applications, and discusses the recent research on the use of electrospun nanofiber incorporating bioactive compounds such as essential oils, herbal bioactive components, plant extracts, and metallic nanoparticles. Inevitably, with the common advantages of bioactive components and polymer nanofibers, electrospun nanofibers containing bioactive components have attracted intense interests for their applications in biomedicine and cancer treatment. Many studies have only concentrated on the production and performance of electrospun nanofiber loaded with bioactive components; in this regard, the features of different types of electrospun nanofiber incorporating a wide variety of bioactive compounds and their developing trends are summarized and assessed in the present article, as is the feasible use of nanofiber technology to produce products on an industrial scale in different applications

Balanced Crystalloids versus Normal Saline in Adults with Sepsis: A Comprehensive Systematic Review and Meta-Analysis

The crystalloid fluid of choice in sepsis remains debatable. We aimed to perform a comprehensive meta-analysis to compare the effect of balanced crystalloids (BC) vs. normal saline (NS) in adults with sepsis. A systematic search of PubMed, EMBASE, and Web of Sciences databases through 22 January 2022, was performed for studies that compared BC vs. NS in adults with sepsis. Our outcomes included mortality and acute kidney injury (AKI), need for renal replacement therapy (RRT), and ICU length of stay (LOS). Pooled risk ratio (RR) and mean difference (MD) with the corresponding 95% confidence intervals (CIs) were obtained using a random-effect model. Fifteen studies involving 20,329 patients were included. Overall, BC showed a significant reduction in the overall mortality (RR 0.88, 95% CI 0.81-0.96), 28/30-day mortality (RR 0.87, 95% CI 0.79-0.95), and AKI (RR 0.85, 95% CI 0.77-0.93) but similar 90-day mortality (RR 0.96, 95% CI 0.90-1.03), need for RRT (RR 0.91, 95% CI 0.76-1.08), and ICU LOS (MD -0.25 days, 95% CI -3.44, 2.95), were observed between the two groups. However, subgroup analysis of randomized controlled trials (RCTs) showed no statistically significant differences in overall mortality (RR 0.92, 95% CI 0.82-1.02), AKI (RR 0.71, 95% CI 0.47-1.06), and need for RRT (RR 0.71, 95% CI 0.36-1.41). Our meta-analysis demonstrates that overall BC was associated with reduced mortality and AKI in sepsis compared to NS among patients with sepsis. However, subgroup analysis of RCTs showed no significant differences in both overall mortality and AKI between the groups. There was no significant difference in the need for RRT or ICU LOS between BC and NS. Pending further data, our study supports using BC over NS for fluid resuscitation in adults with sepsis. Further large-scale RCTs are necessary to validate our findings

Stability studies of nano-cream containing piroxicam

The aim of this study is to study the stability of the nano-cream formula containing the newly synthesized palm oil esters when stored for reasonable storage duration. The prepared 0.5% piroxicam nano-cream formula contained phosphate buffer as external phase, palm oil esters as the oil phase and a combination of (80:20) of Tween 80 and Span 20 as emulsifier at a ratio of 37:25:38, respectively. Piroxicam is a hydro-lipophobic drug. Stability on storage is an important aspect which ensures the dosage form can exert the effects it is supposed to exert for the duration of storage. Droplets size, electrical conductivity, drug content, pH and rheological parameters are the parameters that have been assessed under different temperature to evaluate the stability of nano-cream preparation. Thus, experiments which measure the above parameters were conducted at storage temperatures of 4, 25 and 40οC.The data obtained from the stability study conducted on nano-cream formula showed that this formulation was stable for the whole 3 months period of the study when stored at tested several temperatures.Keywords: Palm oil esters; Nonionic surfactant; Piroxicam; Nano-crea

Stability studies of nano-cream containing piroxicam

The aim of this study is to study the stability of the nano-cream formula containing the newly synthesized palm oil esters when stored for reasonable storage duration. The prepared 0.5% piroxicam nano-cream formula contained phosphate buffer as external phase, palm oil esters as the oil phase and a combination of (80:20) of Tween 80 and Span 20 as emulsifier at a ratio of 37:25:38, respectively. Piroxicam is a hydro-lipophobic drug. Stability on storage is an important aspect which ensures the dosage form can exert the effects it is supposed to exert for the duration of storage. Droplets size, electrical conductivity, drug content, pH and rheological parameters are the parameters that have been assessed under different temperature to evaluate the stability of nano-cream preparation. Thus, experiments which measure the above parameters were conducted at storage temperatures of 4, 25 and 40οC.The data obtained from the stability study conducted on nano-cream formula showed that this formulation was stable for the whole 3 months period of the study when stored at tested several temperatures.Keywords: Palm oil esters; Nonionic surfactant; Piroxicam; Nano-crea

Formulation and characterization of palm oil esters based nano-cream for topical delivery of piroxicam

Palm oil esters are high molecular weight esters oil that has been newly synthesized by University Putra Malaysia researchers. It has received a lot of attention for its pharmaceutical and chemical application. Piroxicam is a nonsteroidal anti-inflammatory drug with analgesic and antipyretic activity. It has low solubility in water as well as in oil with Log P value of 1.8. Generally, drugs with Log P value of more than 0.5 are needed to be formulated into a modified dosage form. One of these formulations is nano sized cream. Hence, the ability of formulating of these tricky drugs into dispersed system is questionable. The aim of this study is to investigate the ability of palm oil esters to be the oil phase for formulation of piroxicam into O/W nano-cream. Three points were selected from prepared pseudoternary diagram of palm oil esters and different Tween and Span mixtures. Piroxicam solubility and partition coefficient in oil and external phase was detected. Rheological properties, droplet size, structural properties and zeta potential of the dispersion system containing piroxicam were measured. O/W cream was formed with droplet size measurement by TEM of less than 100 nm. It could be concluded that palm oil esters is suitable oil for the formulation of suitable nano-cream containing piroxicam.Keywords: Palm oil esters; Piroxicam Solubility; partition coefficient; Rheology; Surface activity

Multinational prospective cohort study of rates and risk factors for ventilator-associated pneumonia over 24 years in 42 countries of Asia, Africa, Eastern Europe, Latin America, and the Middle East: Findings of the International Nosocomial Infection Control Consortium (INICC)

Objective: Rates of ventilator-associated pneumonia (VAP) in low- and middle-income countries (LMIC) are several times above those of high-income countries. The objective of this study was to identify risk factors (RFs) for VAP cases in ICUs of LMICs. Design: Prospective cohort study. Setting: This study was conducted across 743 ICUs of 282 hospitals in 144 cities in 42 Asian, African, European, Latin American, and Middle Eastern countries. Participants: The study included patients admitted to ICUs across 24 years. Results: In total, 289,643 patients were followed during 1,951,405 patient days and acquired 8,236 VAPs. We analyzed 10 independent variables. Multiple logistic regression identified the following independent VAP RFs: male sex (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.16-1.28; P <.0001); longer length of stay (LOS), which increased the risk 7% per day (aOR, 1.07; 95% CI, 1.07-1.08; P <.0001); mechanical ventilation (MV) utilization ratio (aOR, 1.27; 95% CI, 1.23-1.31; P <.0001); continuous positive airway pressure (CPAP), which was associated with the highest risk (aOR, 13.38; 95% CI, 11.57-15.48; P <.0001)Revisión por pare

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe