A comparative assessment of the accuracy of electronic apex locator (Root ZX) in the presence of commonly used irrigating solutions

Objectives: This study aimed to evaluate the accuracy of Root ZX in determining working length in presence of normal saline, 0.2% chlorhexidine and 2.5% of sodium hypochlorite. Material and Methods: Sixty extracted, single rooted, single canal human teeth were used. Teeth were decoronated at CEJ and actual canal length determined. Then working length measurements were obtained with Root ZX in presence of normal saline 0.9%, 0.2% chlorhexidine and 2.5% NaOCl. The working length obtained with Root ZX were compared with actual canal length and subjected to statistical analysis. Results: No statistical significant difference was found between actual canal length and Root ZX measurements in presence of normal saline and 0.2% chlorhexidine. Highly statistical difference was found between actual canal length and Root ZX measurements in presence of 2.5% of NaOCl, however all the measurements were within the clinically acceptable range of ±0.5mm. Conclusion: The accuracy of EL measurement of Root ZX within±0.5 mm of AL was consistently high in the presence of 0.2% chlorhexidine, normal saline and 2.5% sodium hypochlorite. Clinical significance: This study signifies the efficacy of ROOT ZX (Third generation apex locator) as a dependable aid in endodontic working length

Factors Affecting Clinical Performance among Pakistani Dental Students: A Cross-Sectional Study

Objective: To identify the factors affecting clinical performance among dental students and to help addressing these problems. Material and Methods: A cross-sectional study in which students of third and final year of dentistry participated. Data was collected from June 2022 till September 2022. Data was collected from the third and final year dental students of both public and private dental colleges within the Pakistan using a purposive sampling technique. Results: A total of 372 dental students participated in this study. Thirty eight (31.9%) students belonged to third year while 81 (68.1%) were final year students from government college. For the private dental college, 121 (47.8%) were third year students while 132 (52.2%) were final year students. Majority of the participants were males from both the colleges. 42.9% of government dental students and 26.5% of private dental students agreed on well-preparedness of clinical instructors. 5.5% from private and 21.0% from government dental colleges agreed that adequate personal protective equipment were present in clinical departments. Conclusion: From this study, it is concluded that there should be focus more focus on the factors to enhance clinical skills, supervision of students in clinical practice to help addressing the problems faced during learning and performance in a clinical environment, to produce self-confident, motivated, knowledgeable, skillful and a professional dental graduates

Cone Beam Computed Tomography Evaluation of Root Morphology of the Premolars in Saudi Arabian Subpopulation

Objective: To evaluate root canal configuration and morphology of premolar teeth among Saudi subpopulations using cone beam computed tomography (CBCT). Material and Methods: In this retrospective cross-sectional study, CBCT images of 314 patients comprising 346 maxillary and 412 mandibular first premolar (FPM) teeth, 298 maxillary and 387 mandibular second premolar (SPM) teeth were analyzed to evaluate the number of roots, root canal morphology, and configuration based on the Vertucci's classification. The average intra-class correlation coefficient value was 0.931. Results: In the maxillary first premolar, 52.6% were two separate rooted and single rooted teeth, with one canal in 81.2% of the maxillary second premolar. Among the mandibular FPM, 96.6% of the teeth had one root and canal, and 97.9% of mandibular SPM had one root and canal. Type 1 canal configuration was seen as most common in all premolars. The number of roots in mandibular premolars did not reveal the difference among gender. Conclusion: Wide variations in root canal morphology and canal configuration system exists among maxillary and mandibular premolar teeth

Cone Beam Computed Tomography Evaluation of Root Morphology of the Premolars in Saudi Arabian Subpopulation

Objective: To evaluate root canal configuration and morphology of premolar teeth among Saudi subpopulations using cone beam computed tomography (CBCT). Material and Methods: In this retrospective cross-sectional study, CBCT images of 314 patients comprising 346 maxillary and 412 mandibular first premolar (FPM) teeth, 298 maxillary and 387 mandibular second premolar (SPM) teeth were analyzed to evaluate the number of roots, root canal morphology, and configuration based on the Vertucci's classification. The average intra-class correlation coefficient value was 0.931. Results: In the maxillary first premolar, 52.6% were two separate rooted and single rooted teeth, with one canal in 81.2% of the maxillary second premolar. Among the mandibular FPM, 96.6% of the teeth had one root and canal, and 97.9% of mandibular SPM had one root and canal. Type 1 canal configuration was seen as most common in all premolars. The number of roots in mandibular premolars did not reveal the difference among gender. Conclusion: Wide variations in root canal morphology and canal configuration system exists among maxillary and mandibular premolar teeth

Explorando a degradação fotocatalítica do corante laranja de metila usando nanopartículas de óxido de Bismuto dopadas com Estrôncio

Low dimensional metal oxide Nps have garnered significant attention due to their distinctive characteristics and diverse application domains. This investigation can provide further elucidation regarding the synthesis of Strontium doped-Bi2O3 efficacious photocatalysts operating under visible light, thereby potentially addressing environmental quandaries. The photoactivity of Strontium doped-Bi2O3 Nps exhibits a significantly greater magnitude when compared to that of Bi2O3 nanoparticles lacking Strontium doping. The hydrothermal method shall be employed for the synthesis of Strontium-doped Bismuth oxide in the course of preparation. A solution of NH4OH will be introduced to Bismuth nitrate and Strontium chloride. The resulting mixtures shall be subjected to vigorous stirring for a duration of 1 hour, after which they will be transferred into 100 mL autoclaves made of stainless steel and equipped with Teflon liners. These autoclaves shall then be heated to a temperature of 180 °C for a period of 6 h. The prepared samples shall subsequently undergo collection and undergo multiple washes utilising de-ionized water. In order to synthesise Strontium doped-Bi2O3 is imperative to subject the resulting compound to a subsequent calcination process at a temperature of 450° C. Infra-Red spectroscopy (FT-IR), UV-Visible, scanning electron microscopy (SEM), X-ray diffraction (XRD), techniques shall be employed for the investigation of the crystalline structures and morphologies of the powder. The resultant specimen shall subsequently serve as a catalyst for the photolytic degradation of organic dye methyl orange under diverse illumination circumstances. UV-Visible spectroscopy shall subsequently be employed to monitor the extent of photocatalytic efficacy.Os Nps de óxido metálico de baixa dimensão têm atraído atenção significativa devido às suas características distintas e diversos domínios de aplicação. Esta investigação pode fornecer mais esclarecimentos sobre a síntese de fotocatalisadores eficazes dopados com estrôncio-Bi2O3 operando sob luz visível, abordando assim potencialmente dilemas ambientais. A fotoatividade do Bi2O3 Nps dopado com estrôncio exibe uma magnitude significativamente maior quando comparada à das nanopartículas de Bi2O3 sem dopagem com estrôncio. O método hidrotérmico será utilizado para a síntese de óxido de bismuto dopado com estrôncio durante a preparação. Uma solução de NH4OH será introduzida ao nitrato de bismuto e cloreto de estrôncio. As misturas resultantes serão submetidas a agitação vigorosa por 1 h, após o que serão transferidas para autoclaves de 100 mL fabricadas em aço inoxidável e equipadas com liners de Teflon. Estas autoclaves serão então aquecidas a uma temperatura de 180 °C por um período de 6 horas. As amostras preparadas serão posteriormente coletadas e submetidas a múltiplas lavagens utilizando água deionizada. Para sintetizar Bi2O3 dopado com estrôncio é imperativo submeter o composto resultante a um processo de calcinação subsequente a uma temperatura de 450° C. Espectroscopia no infravermelho (FT-IR), UV-Visível, microscopia eletrônica de varredura (SEM), X - difração de raios (DRX), técnicas serão empregadas para a investigação das estruturas cristalinas e morfologias do pó. A amostra resultante servirá posteriormente como um catalisador para a degradação fotolítica do corante orgânico laranja de metila sob diversas circunstâncias de iluminação. A espectroscopia UV-Visível será posteriormente empregada para monitorar a extensão da eficácia fotocatalítica

Formulation development and characterization of quercetin loaded poly caprolactone nanoparticles for tumors

Cancer is a formidable health obstacle, characterized by its bleak outlook. Considerable scientific investigation has shed light on the capacity to modify the dispersion of anticancer medications at various levels within tissues and cells by enclosing them within submicronic colloidal systems, often known as nanoparticles. This approach is based on the goal of enhancing the therapeutic effectiveness of these medications while minimizing adverse effects on the entire body. Moreover, the theragnostic characteristics of these nanoparticles are widely acknowledged, hence enhancing their therapeutic potential. The current study is centered on exploring the potential anti-tumor effects of quercetin by utilizing its antioxidant capabilities. The quercetin nanoparticles are synthesized with great precision utilizing the nanoprecipitation approach, in which poly(caprolactone) is utilized as the polymer matrix. Following synthesis, the nanoparticles are extracted for further analysis. Further attempts are undertaken to enhance the drug loading process, and the resultant nanoparticles undergo a thorough analysis, including the examination of their morphology using scanning electron microscopy, and the evaluation of drug-polymer interactions using Fourier transform infrared spectroscopy and differential scanning calorimetry. The remarkable efficacy of quercetin's envelopment can be attributed to its lipophilic nature, reaching a maximum of 81%. The utilization of scanning electron microscopy allows for the observation of nanoparticles with varying forms. Conversely, the absence of noticeable interactions in Fourier-transform infrared analysis indicates the stability of poly(caprolactone) nanoparticles loaded with quercetin

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Design and Simulation of Microstrip Phase Array Antenna using ADS

The aim of this project is to design a microstrip phase array antenna in ADS (Advance Design System) Momentum. The resonant frequency of which is 10 GHz. Two circular patches with a radius of 5.83 mm each are used in designing the array antenna. RT-DURROID 5880 is used as a substrate for this microstrip patch array design. These circular patches are excited using coaxial probe feed and transmission lines of particular lengths and widths. These transmission lines perfectly match the impedance of the circular patches. Various parameters, for example the S-parameters, two dimensional and three dimensional radiation patterns, excitation models, gain, directivity and efficiency of the designed antenna are obtained from ADS Momentum.