Factors associated with Non-Carious Cervical Lesions (NCCLs) in teeth

OBJECTIVE: To determine factors associated with Non-Carious Cervical Lesions (NCCLs) and the teeth most commonly involved in such lesions. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Operative Dentistry, Section of Dentistry at Aga Khan University Hospital, Karachi, Pakistan, from December 2005 to January 2006. METHODOLOGY: A total number of 95 patients with 671 teeth were evaluated using a pre-coded questionnaire. Subject of evaluation was teeth. Patients with symptomatic or asymptomatic NCCLs and permanent dentition were included. Patients exhibiting active, untreatable periodontal disease, rampant uncontrolled caries, xerostomia, primary dentition, patients undergoing orthodontic treatment or bleaching procedure were excluded from the study. Data analysis was done using Spearman\u27s correlation, Mann Whitney test and Kruskal-Wallis test. RESULTS: Mean age of patients was 50.3 years (r=0.22, p=0.028); males (73%) had more NCCLs than females (23%). Majority (45.3%) of them brushed their teeth twice a day, with medium type of brush (48.4%) and horizontal (73.7%) brushing technique. Most of the patients were non-bruxists (90.5%), with Angles Class 1 occlusion (48.4%) and canine guidance (50.5%). Majority (74.7%) of the patients did not have sensitivity. CONCLUSION: First premolars in all the quadrants were the most frequently involved teeth in NCCLs. More males had NCCLs. Middle aged patients were more involved. A weak positive correlation was found between age and NCCLs. No association was observed between hand used and site of NCCLs, between wear facets and NCCL, Excursive guidance and NCCL, Angles classification and NCCL

Frequency and Distribution of Endodontically Treated Teeth

Objective: To determine the distribution and pattern of carious teeth involvement in permanent teeth requiring endodontic treatment. Study Design: Cross-sectional study. Place and Duration of Study: Dental Section of The Aga Khan University Hospital, Karachi, from September 2004 to March 2005. Methodology: Data was collected from the dental records of patients. Tooth was the unit of evaluation. Variables studied were demographics, tooth type, etiology of endodontic treatment and pattern of caries involvement. Data was analyzed using chi-square test and Fischer’s exact test. Results: The total number of patients was 190; total number of teeth involved were 235. Females had more endodontically treated teeth than males. There was no significant difference in the distribution of etiology of endodontic treatment in both genders (p=0.564). An increasing trend of endodontic procedure was observed with the increasing age of patients. Caries was the most common etiological factor leading to endodontic treatment (p = 0.011). Class-II cavity i.e. proximal surface of teeth was the most commonly involved surface in endodontically involved teeth (p \u3c 0.001). More molars had been endodontically treated followed by premolars and anterior teeth. Conclusion: Caries was the most common etiologic factor; lower molars were the most commonly involved and lower anteriors the least commonly involved teeth in endodontic procedure. Significant association was observed between etiology and tooth type. Significant association was found between cavity classification and etiology of endodontic treatment with class-II caries being most common

DESIGN AND EVALUATION OF DOMPERIDONE SUBLINGUAL TABLETS

Objective: The aim of this work was to enhance the bioavailability of poorly soluble, anti-emetic drug; domperidone (DMP) having a poor oral bioavailability (13-17%) due to extensive first pass metabolism. The goal of this study was achieved through solubilization of DMP using solid dispersion technology followed by incorporation of solid dispersions into sublingual tablets to bypass pre-systemic metabolism.Methods: Solid dispersions of DMP with Pluronic F-68 were prepared in different weight ratios by fusion method and they were evaluated for their in vitro dissolution rate to select the best ratio for final formulation. Then, solid dispersions were formulated into sublingual tablets in combination with various soluble excipients. Sublingual tablets were prepared by direct compression technique and evaluated for their physical properties, in vitro dissolution rate and kinetics of drug release. The best formulae were selected for in vivo studies in rabbits in comparison with marketed oral tablets; Motinorm®.Results: Solid dispersions of DMP with Pluronic F-68 in a weight ratio of 1:7 (w/w) showed the highest dissolution rate and were selected for sublingual tablets formulation. Sublingual tablets formulae S16 (containing Fructose and 10% w/w Ac-Di-Sol) and S20 (containing Fructose and 10% w/w Explotab) showed the best results and were selected for in vivo studies in rabbits. The selected formulae showed marked enhancement of DMP bioavailability compared with the commercial oral tablets; Motinorm®, with relative bioavailability values of 432.49±10.13% and 409.32±11.59 % for S16 and S20, respectively.Conclusion: The results confirmed that sublingual tablets were an effective tool for DMP delivery with marked enhancement of bioavailability.Keywords: Domperidone, Solubility, Solid dispersions, Sublingual tablets, First-pass metabolism, Bioavailabilit

Influence of Some Innovation Attributes on the Adoption of Growing Sunflower in Rahad Scheme

The vital economic importance of sunflower as one of the oil crops encouraged its introduction to the Sudan in the last twenty years. The production of sunflower crop began in Rahad scheme, as in other irrigated areas in the country, in 1992/93 growing season. Field survey was used to collect data from 100 sunflower growers (adopters) in Rahad Scheme (block 10) in 2002/2003 growing season selected from a total population of 1000-1100 farmers by using the simple random sample technique. An equal number of non-adopters was selected for comparison. The total number of interviewed farmers was 200. The collected data was statistically analyzed using the chi-square test. The results showed significant association (dependency) between adoption of growing sunflower (the innovation) and some of its attributes: Relative advantage on perceived production cost and income, compatibility with farmers need as cash crop and animal feed, complexity associated with use of technical package for sunflower. From the findings of this study, we can conclude that the adoption of this crop was dependent on some innovation attributes and the results were expected to reveal factors influencing adoption of the crop. The authors recommend that more attention should be given by agronomists to this crop in order to improve the yield of the crop and extension services should design special programs for the crop to promote its rate of adoption

Memory embedded non-intrusive reduced order modeling of non-ergodic flows

Generating a digital twin of any complex system requires modeling and computational approaches that are efficient, accurate, and modular. Traditional reduced order modeling techniques are targeted at only the first two but the novel non-intrusive approach presented in this study is an attempt at taking all three into account effectively compared to their traditional counterparts. Based on dimensionality reduction using proper orthogonal decomposition (POD), we introduce a long short-term memory (LSTM) neural network architecture together with a principal interval decomposition (PID) framework as an enabler to account for localized modal deformation, which is a key element in accurate reduced order modeling of convective flows. Our applications for convection dominated systems governed by Burgers, Navier-Stokes, and Boussinesq equations demonstrate that the proposed approach yields significantly more accurate predictions than the POD-Galerkin method, and could be a key enabler towards near real-time predictions of unsteady flows

Household-level risk factors for secondary influenza-like illness in a rural area of Bangladesh

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Objective To describe household‐level risk factors for secondary influenza‐like illness (ILI), an important public health concern in the low‐income population of Bangladesh. Methods Secondary analysis of control participants in a randomised controlled trial evaluating the effect of handwashing to prevent household ILI transmission. We recruited index‐case patients with ILI – fever (<5 years); fever, cough or sore throat (≥5 years) – from health facilities, collected information on household factors and conducted syndromic surveillance among household contacts for 10 days after resolution of index‐case patients’ symptoms. We evaluated the associations between household factors at baseline and secondary ILI among household contacts using negative binomial regression, accounting for clustering by household. Results Our sample was 1491 household contacts of 184 index‐case patients. Seventy‐one percentage reported that smoking occurred in their home, 27% shared a latrine with one other household and 36% shared a latrine with >1 other household. A total of 114 household contacts (7.6%) had symptoms of ILI during follow‐up. Smoking in the home (RRadj 1.9, 95% CI: 1.2, 3.0) and sharing a latrine with one household (RRadj 2.1, 95% CI: 1.2, 3.6) or >1 household (RRadj 3.1, 95% CI: 1.8–5.2) were independently associated with increased risk of secondary ILI. Conclusion Tobacco use in homes could increase respiratory illness in Bangladesh. The mechanism between use of shared latrines and household ILI transmission is not clear. It is possible that respiratory pathogens could be transmitted through faecal contact or contaminated fomites in shared latrines

Perinatal outcomes following Helping Babies Breathe training and regular peer-peer skills practice among village midwives in Sudan.

Over 80% of deliveries in Sudan occur in rural areas, attended by village midwives (VMWs). To determine the impact of Helping Babies Breathe training and regular peer-peer skills practice (HBBT(+RPPSP)) on VMW resuscitation practices and outcomes. In a prospective community-based intervention study, 71/82 VMWs, reporting to six East Nile rural medical centres, with previous experience in community health research, consented to HBBT(+RPPSP). Outcomes included changes in the resuscitation practices, fresh stillbirths (FSB) and early neonatal deaths <1 week (ENND). There were 1350 and 3040 deliveries before and after HBBT(+RPPSP), respectively, with no significant differences between the two cohorts regarding maternal age, education or area of birth. Drying of the newborn increased almost tenfold (8.4%, n=113 to 74.9%, n=1011) while suctioning of the mouth/nose decreased fivefold (80.3%, n=2442 to 14.4%, n=437) following HBBT(+RPPSP). Pre-HBBT(+RPPSP)9/18 (50%) newborns who had mouth-to-mouth ventilation died, compared with 13/119 (11%) who received bag-mask ventilation post-HBBT(+RPPSP). Excluding 11 macerated fetuses, there were 55 perinatal deaths: 14 FSB/18 ENND (6 months pre-HBBT(+RPPSP)) and 10 FSB/13 ENND (18 months post-HBBT(+RPPSP)). FSB rates decreased from 10.5 to 3.3 per 1000 births ((χ(2))=8.6209, p=0.003), while ENND rates decreased from 13.5 to 4.3 per 1000 live births ((χ(2))=10.9369, p=0.001) pre-HBBT(+RPPSP) and post-HBBT(+RPPSP), respectively. In a selected group of VMWs, HBBT(+RPPSP) was associated with improvements in newborn resuscitation and perinatal outcomes. HBBT(+RPPSP) could have immense benefits if propagated nationally to all 17 000 VMWs in Sudan.This study was funded by the Irish Aid Civil Society Grant scheme

A neoclerodane orthoester and other new neoclerodane diterpenoids from Teucrium yemense chemistry and effect on secretion of insulin

Teucrium yemense, a medicinal plant commonly grown in Saudi Arabia and Yemen, is traditionally used to treat infections, kidney diseases, rheumatism, and diabetes. Extraction of the dried aerial parts of the plant with methanol, followed by further extraction with butanol and chromatography, gave twenty novel neoclerodanes. Their structures, relative confgurations and some conformations were determined by MS and 1-D and 2-D NMR techniques. Most were fairly conventional but one contained an unusual stable orthoester, one had its (C-16)–(C-13)–(C-14)–(C-15) (tetrahydro)furan unit present as a succinic anhydride and one had a rearranged carbon skeleton resulting from ring-contraction to give a central octahydroindene bicyclic core, rather than the usual decalin. Mechanisms are proposed for the biosynthetic formation of the orthoester and for the ring-contraction. Four novel neoclerodanes increased the glucose-triggered release of insulin from isolated murine pancreatic islets by more than the standard drug tolbutamide, showing that they are potential leads for the development of new anti-diabetic drugs

Does health worker performance affect clients' health behaviors? A multilevel analysis from Bangladesh

Background Suboptimal healthcare quality may be a barrier to achieving child health improvements, yet little is known about the relationship between provider compliance with evidence-based practices and client behavior change. We assess provider compliance in the context of infant and young child feeding (IYCF) counseling, its relationship with client IYCF behaviors in Bangladesh, and explore its potential determinants. Methods We use data from a 2017 evaluation of an IYCF program that includes a health worker survey (n = 74), caregiver survey (n = 232), and direct service observation checklists of counseling sessions (n = 232 observations of 74 health workers). We assess the relationship between provider compliance with recommended IYCF counseling topics and behaviors (standardized to a 100-point scale) and three reported IYCF behaviors among clients using multi-level models with random effects at the health worker and sub-district (sampling) levels. We also evaluate whether health worker self-efficacy, satisfaction, and technical knowledge are associated with provider compliance. Results Health worker compliance was significantly associated with reported exclusive breastfeeding for children under 6 months of age (adjusted odds ratio per 1 percentage point increase in counseling compliance score = 1.06, 95% CI 1.01, 1.12) and marginally associated with minimum dietary diversity (adjusted odds ratio per 1 percentage point increase in counseling compliance score = 1.05, 95% CI 1.00, 1.11). Counseling compliance was significantly and positively associated with both health worker self-efficacy and technical knowledge. Conclusions We find evidence for an association between health worker compliance and client health behaviors; however, small effect sizes suggest that behavior change is multifactorial and affected by factors beyond care quality. Improvements to technical quality of care may contribute to desired health outcomes; but policies and programs seeking to change health behaviors through counseling may also wish to target upstream factors such as self-efficacy, alongside technical skill-building and knowledge, for maximum impact.This research was conducted with support from FHI Solutions LLC, via the Alive & Thrive project which is funded by the Bill & Melinda Gates Foundation and the governments of Canada and Ireland