Prosthetic rehabilitation of edentulous mandible with two-implant retained fixed hybrid prosthesis: A case report

Removable complete dentures have been the most costeffective treatment option for edentulous jaws since decades. However, certain problems are encountered by the patients such as stability of the lower dentures resulting in poor masticatory efficiency. Ridge resorption and inadequate bony support are the long-term complications comprising the stability of the denture and patient finding it difficult to control denture movement during speaking and eating reducing patient compliance. Mandibular implant retained over dentures or hybrid dentures have shown to be better alternatives in terms of retention, stability and patient satisfaction. Two implants provide cost-effective, stabilized and comfortable treatment options. The present case report discusses the management of the patient with compromised dentition in which all teeth were extracted followed by conventional upper complete denture and lower two implant supported fixed hybrid dentures with splinted bar attachmen

Relapse Rate after Opioid Detoxification in Drug Addict Patients

Background: Drug addiction is widely regarded as a pathological condition that involves the continued abuse of drugs in the development of drug-seeking behavior and a decrease in the ability to respond to naturally rewarding stimuli. Objective: To determine the frequency of relapse after opioid detoxification in drug addict patients. Methods: A descriptive cross-sectional survey was performed in psychiatry department of Pakistan Institute of Medical Sciences, PIMS, Islamabad, from October 2017 to April 2018. All adult patients who were using cannabis for at least 1 year, irrespective of gender ages between 18 to 60 years were included in the study. For drug use characteristics about preferred choice of drugs and injection-related risk behaviors were noted and analyzed. All findings were entered in a structured Proforma. Data was entered in SPSS version 21 and analyzed. Effects modifiers like age, gender, marital status, types of drugs, etc., were controlled by stratification. Post stratification chi square test was applied. A p value ≤ 0.05 was considered significant. Results: Total 310 patients were included; 83% patients were male and 17% were females. The mean age of the patients was 39.02±21.42 years. 70% patients had relapse after opioid detoxification while 30% patients had NO relapse. The relapse rate after detoxification was more common in first month of detoxification (56%). After 3 months the relapse rate after detoxification was 12.5%. The statistical analysis showed that there was a very significant association between types of drugs, ages of patients, marital status and relapse rate (p ≤ 0.05). There was an insignificant association between gender and relapse rate (p ≥ 0.5). Conclusion: The study concluded that the relapse within six months of opioid detoxification in drug addicts is very common. Many factors contribute in relapse rate

Assessment of contamination on sterilised dental burs after being subjected to various pre-cleaning methods

OBJECTIVE: To determine the effectiveness of different pre-cleaning methods by determining frequency and site of contamination on the sterilised dental burs using Phloxine B dye. METHODS: The in-vitro experimental study was conducted from June to August 2017 at dental clinics of Aga Khan University Hospital Karachi. Diamond dental burs were selected and divided into two control and four test groups. The two control groups were classified as Negative (new burs) and Positive (used contaminated). The four test groups were classified as Manual (Group-1), Ultrasonic (Group-2), Manual + Enzyme (Group-3) and Manual + Ultrasonic (Group-4). Phloxine B dye was used to determine the contamination. The images of the burs were taken and enlarged at 15X before subjected to visual assessment. Association between contamination and pre-cleaning methods were determined. Data was analysed using SPSS version 22. RESULTS: A total of 210 burs were selected for the study which were divided in 6 groups of 35(16.66%) each. One (2.8%) bur in negative control group and all burs in positive control group showed contamination. In test groups, 27(77.1%), 29(82.8%), 27(77.1%) and 24(68.5%) burs showed contamination in groups 1, 2, 3 and 4, respectively. There was no association between type of pre-cleaning method with the frequency of contamination (p =0.57). The head of bur was the most frequently contaminated site (p \u3c 0.003). CONCLUSIONS: None of the pre-cleaning method was found to be effective. Head of bur was the most frequently contaminated site

Relapse Rate after Opioid Detoxification in Drug Addict Patients

Background: Drug addiction is widely regarded as a pathological condition that involves the continued abuse of drugs in the development of drug-seeking behavior and a decrease in the ability to respond to naturally rewarding stimuli. Objective: To determine the frequency of relapse after opioid detoxification in drug addict patients. Methods: A descriptive cross-sectional survey was performed in psychiatry department of Pakistan Institute of Medical Sciences, PIMS, Islamabad, from October 2017 to April 2018. All adult patients who were using cannabis for at least 1 year, irrespective of gender ages between 18 to 60 years were included in the study. For drug use characteristics about preferred choice of drugs and injection-related risk behaviors were noted and analyzed. All findings were entered in a structured Proforma. Data was entered in SPSS version 21 and analyzed. Effects modifiers like age, gender, marital status, types of drugs, etc., were controlled by stratification. Post stratification chi square test was applied. A p value ≤ 0.05 was considered significant. Results: Total 310 patients were included; 83% patients were male and 17% were females. The mean age of the patients was 39.02±21.42 years. 70% patients had relapse after opioid detoxification while 30% patients had NO relapse. The relapse rate after detoxification was more common in first month of detoxification (56%). After 3 months the relapse rate after detoxification was 12.5%. The statistical analysis showed that there was a very significant association between types of drugs, ages of patients, marital status and relapse rate (p ≤ 0.05). There was an insignificant association between gender and relapse rate (p ≥ 0.5). Conclusion: The study concluded that the relapse within six months of opioid detoxification in drug addicts is very common. Many factors contribute in relapse rate

Visual and microscopic evaluation of the surface alterations In the protaper files after single clinical use

BACKGROUND: Different studies have been conducted in which defects of Ni-Ti files were reported after multiple usages but limited data is available regarding the defects in the rotary Ni-Ti files subjected to single clinical use. The objective of this study was to determine the frequency of surface defects caused by fatigue in the rotary ProTaper files after single clinical use assessed with visual and microscopic examination methods. METHODS: A cross-sectional study was conducted in the dental clinics of The Aga Khan University Hospital, Karachi, Pakistan. A total of 189 ProTaper Ni-Ti files (after single clinical use in multi-rooted molars) were analysed visually and then under stereomicroscope at 10Χ magnification for surface defects (straightening, denting, bending, twisting, pitting and change in length). Chi Square test was used to determine association between type of file and type of defect. Spearman\u27s correlation test was used for determination of correlation between visual and microscopic examinations at 0.05 level of significance. RESULTS: 19% of files showed straightening on visual assessment as compared to 66.1% under microscopic examination. There was a statistically significant association between the file type and the straightening of file (p-value ≤0.001). A weak correlation existed between visual and microscopic examination for all the defects, except for the change in length. CONCLUSIONS: The defects of ProTapers files are best detected by the microscopic examination. Straightening is the most common defect observed visually and microscopically. The first shaping and first finishing files underwent significantly more surface defects than the rest of the rotary files in the series

Most effective method for the management of physiologic gingival hyperpigmentation: A systematic review and meta-analysis

MATERIALS AND METHODS: A systematic review and meta-analysis were done (1919 to October 2018) using PubMed, CINHAL, Dental and Oral Science, and manual searches. Twenty-five articles were finally reviewed. Only human clinical trials were considered with physiological gingival pigmentation treated with different depigmentation methods and compared with surgical stripping. The outcome was the achievement of gingival depigmentation and its recurrence. RevMan software was used for data analysis. RESULTS: Of 26,132 articles, 25 met the inclusion criteria. Seventeen were randomized control trials and 8 were nonrandomized control trials. Most of the studies were on laser. The control group was scalpel surgery. Majority of studies showed no difference in compared treatment modality. A meta-analysis compared laser ablation with surgical stripping revealed a nonsignificance difference regarding recurrence (P = 0.75) and depigmentation (P = 0.23) and a statistically significant difference regarding postoperative pain favoring laser ablation (P ≤ 0.05). CONCLUSIONS: Surgical stripping has been the conventional treatment of choice, but our review showed that new techniques are equally effective or even better. Laser especially diode laser was the most frequently used technique and showed better esthetic outcomes, less pain, faster healing, and patients\u27 preference and satisfaction after treatment. However, laser showed more regimentation at 6-month evaluation. More good quality randomized controlled trials with different depigmentation methods are needed to draw strong conclusions

Determine the Severity of Acute Respiratory Infections by Using Pediatric Respiratory Severity Score (PRESS) in Children Visiting Federal Govt. Polyclinic hospital, Islamabad

Objective: To determine the severity of acute respiratory infections in children by using Pediatric Respiratory Severity Score (PRESS). Methodology: This descriptive cross sectional study was conducted at the outpatient and emergency paediatric department of the Federal Govt. Polyclinic hospital, Islamabad, from October 2017 to December 2019. One hundred and seventeen children with acute respiratory infections were enrolled in the study by a non-probability sampling technique. Epidemiologic variables of interest included age, sex, and breastfeeding or not. Clinical variables of interest included respiratory rate, use of accessory respiratory muscle, wheeze on auscultation, and oxygen saturation at room air.  PRESS assessed tachypnea, wheezing, accessory muscle use, SpO2 and feeding difficulties with each component given a score of 0 or 1, and the total score were categorized as a mild(0-1), moderate (2-3) or severe(4-5). Results: Out of 117 children, 98 (83.8%) belonged to the age group > 2 months– 12 months, while 19 (16.2%) belonged to the age group > 12 months– 24 months. Among them, 17 (14.5%) were mild, 53 (45.3%) were moderate, and 47 (40.2%) were severe according to their severity of respiratory distress. The hospitalization rate for moderate infection was 84.9% while 100% for severe infection and none of the patient with mild infection was hospitalized (p<0.001). Conclusion: Early assessment by simple bedside technique will help in managing the respiratory distress according to its severity, reducing the undue investigation and improving the outcome of illness. Moreover it can be easily administered at primary health care facilities for triage of pediatric patients with respiratory distress

Chemical Biology Toolsets for Drug Discovery and Target Identification

Chemical biology is the scientific discipline that deals with the application of chemical techniques and often small molecules produced through synthetic chemistry, to the manipulation and study of biological systems. Its working framework ranges from simple chemical entities to complex drugs by employing the principles of biological origin. This chapter particularly focuses on the principles and working models of chemical biology to discover new drug leads. Drug discovery is an extensive and multifaceted complex process. Chemical biology uses both natural and synthetic compounds with the best therapeutic potential and verifies them by employing the best possible chemical toolsets. Screening of compounds is done by the use of phenotypic as well as the target-based screening to identify and characterize the potent hits. After the identification of target, it is characterized, and validated by extensive testing. The next step is the validation of hits obtained, and lead compounds are tested in clinical trials before introducing them for commercial application

Food supplements to reduce stunting in Pakistan: A process evaluation of community dynamics shaping uptake

Background: There is an increasing interest in use of food supplements to prevent childhood stunting, however the evidence on the process indicators is scarce. We in this study explore the barriers to the effective implementation of food supplementation programs and the possible mitigation strategies which can guide the design of future programs.Methods: We undertook a process evaluation of a stunting prevention food supplementation pilot program in rural Pakistan that distributed Wheat Soy Blend (WSB) to pregnant & lactating women, and Lipid-based Nutrient Supplement (LNS) and micronutrient powder (MNP) to \u3c 5 years children. We used a mixed methods approach through a quantitative survey of 800 households and conducted 18 focused group discussion (FGDs) (with male and female caregivers), 4 FGDs (with Community Health Workers (CHWs)) and 22 key informant interviews (with district stakeholders) to evaluate the community side factors affecting uptake through five parameters: value, acceptability, receipt of supplement, usage and correct dosage.Results: The findings show that proportionately few beneficiaries consumed the full dose of supplements, despite reasonable knowledge amongst caregivers. Sharing of supplements with other household member was common, and the full monthly stock was usually not received. Qualitative findings suggest that caregivers did not associate food supplements with stunting prevention. WSB was well accepted as an extra ration, LNS was popular due its chocolaty taste and texture, whereas MNP sprinkles were perceived to be of little value. The cultural food practices led to common sharing, whereas interaction with CHWs was minimal for nutrition counselling. Qualitative findings also indicate CHWs related programmatic constraints of low motivation, multi-tasking, inadequate counselling skills and weak supervision.Conclusion: We conclude that the community acceptability of food supplements does not translate into optimal consumption. Hence a greater emphasis is needed on context specific demand creation and focusing on the supply side constraints with improved logistical planning, enhanced motivation and supervision of community workers with involvement of multiple stakeholders. While, similar studies are needed in varying contexts to help frame universal guidelines.Trial registration: ClinicalTrials.gov Identifier: NCT02422953 . Registered on April 22, 2015

Genome-wide analysis, identification, evolution and genomic organization of dehydration responsive element-binding (DREB) gene family in Solanum tuberosum

Background The dehydration responsive element-binding (DREB) gene family plays a crucial role as transcription regulators and enhances plant tolerance to abiotic stresses. Although the DREB gene family has been identified and characterized in many plants, knowledge about it in Solanum tuberosum (Potato) is limited. Results In the present study, StDREB gene family was comprehensively analyzed using bioinformatics approaches. We identified 66 StDREB genes through genome wide screening of the Potato genome based on the AP2 domain architecture and amino acid conservation analysis (Valine at position 14th). Phylogenetic analysis divided them into six distinct subgroups (A1–A6). The categorization of StDREB genes into six subgroups was further supported by gene structure and conserved motif analysis. Potato DREB genes were found to be distributed unevenly across 12 chromosomes. Gene duplication proved that StDREB genes experienced tandem and segmental duplication events which led to the expansion of the gene family. The Ka/Ks ratios of the orthologous pairs also demonstrated the StDREB genes were under strong purification selection in the course of evolution. Interspecies synteny analysis revealed 45 and 36 StDREB genes were orthologous to Arabidopsis and Solanum lycopersicum, respectively. Moreover, subcellular localization indicated that StDREB genes were predominantly located within the nucleus and the StDREB family’s major function was DNA binding according to gene ontology (GO) annotation. Conclusions This study provides a comprehensive and systematic understanding of precise molecular mechanism and functional characterization of StDREB genes in abiotic stress responses and will lead to improvement in Solanum tuberosum