The Factors Affecting Long-Term Stability in Anterior Open-Bite Correction - A Systematic Review

Objective:The present systemic review was conducted with the main purpose to evaluate the quantitative effects of orthognathic surgeries, extraction versus non-extraction treatment, and the type of malocclusion in the stability of anterior open-bite (AOB) correction over the long-term.Methods:The systematic search for studies was conducted through MEDLINE, CINAHL, EMBASE, Scopus, PsychINFO, various key journals, and review articles; November 30, 2016, was the last date for the search. The Quality Assessment Tool for Quantitative Studies was used to grade the methodological quality of the studies.Results:The present review included 14 studies. Stability of the corrected AOB ranged from 61.9% to 100%. The studies with orthognathic surgeries showed a stability of 70–100%. The studies without orthognathic surgeries showed the stability of 61.9–96.7%. All of the studies were retrospective. The mean change in AOB before (T1) and after treatment (T2-T1) was 0.1 mm to 6.93 mm and the mean change in overbite from T2 to T3 (T3-T2) was −0.06 mm to 2.5 mm.Conclusion:Studies with orthognathic surgeries presented with high amount of long-term stability in corrected AOB. No significant difference was noticed in relation to the type of malocclusion and extraction or non-extraction cases

Changes in Upper Airway Dimensions Following Orthodontic Treatment of Skeletal Class II Malocclusion with Twin Block Appliance: A Systematic Review

Objective:This systematic review intends to evaluate the dimensional changes in upper airway dimensions (UAD) of the respiratory tract subsequent to orthodontic treatment of skeletal Class II malocclusion with Twin Block Appliance (TBA).Methods:The quality of reporting systematic reviews and meta-analyses was decided by the PRISMA standards with PROSPERO registration number CRD42017060317. The systematic search included EMBASE, MEDLINE, Psych INFO, Scopus, CINAHL, and other reference journals and review articles. The article search was performed from March 2017 until November 2017. Cochrane's risk of bias in non-randomized studies – of interventions (ROBINS-I) was used to grade the methodological quality of the included studies.Results:The screening procedure identified 302 studies, among which seven studies satisfied the inclusion criteria for eligibility. The UAD at the pretreatment time varied from 7.2 mm to 41.9 mm with a mean of 14.16 mm. The post-treatment change in UAD ranged from 8.2 mm to 43.7 mm with a mean of 15.6 mm.Conclusion:There was a significant increase in UAD following the TBA treatment in the patient group as compared to the control group

Gingival Biotype and Its Relation with Malocclusion

Objective:To systematically review the relationship between gingival biotype (GT) and malocclusion.Methods:The review followed PRISMA standards of quality for systematic reviews and meta-analyses reporting with PROSPERO registration number CRD42020126543. The systematic database search included MEDLINE, Scopus, Embase, PsychINFO, CINAHL, and other key journals; the article search was performed until February 2020. Cochrane’s risk of bias in non-randomized studies-of interventions (ROBINS-I) was used to grade the methodological quality of the included studies.Results:The systematic search identified 105 studies, six studies satisfied the inclusion criteria for eligibility. The study participants ranged from 26 to 200 (total n=812), with a mean of 135. Study participants were aged between 14 and 32 years. Five studies were graded as the moderate risk of bias and one study as low risk of bias. Two studies showed thin GT among individuals with severe crowding compared to mild crowding. Three studies showed a thin GT with a narrow zone of the keratinized gingival width compared to a thick GT. No relationship was found between GT and Angle’s classification of malocclusion.Conclusion:No relationship was observed between Angle’s classification of malocclusion and GT. Thin GT was prevalent among individuals with pro-inclination of incisors. Keratinized gingival width was narrow among individuals with thin GT

Synthesis of Silver Nanoparticles from Extracts of Wild Ginger (Zingiber zerumbet) with Antibacterial Activity against Selective Multidrug Resistant Oral Bacteria

Antibiotic resistance rate is rising worldwide. Silver nanoparticles (AgNPs) are potent for fighting antimicrobial resistance (AMR), independently or synergistically. The purpose of this study was to prepare AgNPs using wild ginger extracts and to evaluate the antibacterial efficacy of these AgNPs against multidrug-resistant (MDR) Staphylococcus aureus, Streptococcus mutans, and Enterococcus faecalis. AgNPs were synthesized using wild ginger extracts at room temperature through different parameters for optimization, i.e., pH and variable molar concentration. Synthesis of AgNPs was confirmed by UV/visible spectroscopy and further characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy analysis (EDXA), and Fourier-transform infrared spectroscopy (FTIR). Disc and agar well diffusion techniques were utilized to determine the in vitro antibacterial activity of plant extracts and AgNPs. The surface plasmon resonance peaks in absorption spectra for silver suspension showed the absorption maxima in the range of 400–420 nm. Functional biomolecules such as N–H, C–H, O–H, C–O, and C–O–C were present in Zingiber zerumbet (Z. zerumbet) (aqueous and organic extracts) responsible for the AgNP formation characterized by FTIR. The crystalline structure of ZZAE-AgCl-NPs and ZZEE-AgCl-NPs was displayed in the XRD analysis. SEM analysis revealed the surface morphology. The EDXA analysis also confirmed the element of silver. It was revealed that AgNPs were seemingly spherical in morphology. The biosynthesized AgNPs exhibited complete antibacterial activity against the tested MDR bacterial strains. This study indicates that AgNPs of wild ginger extracts exhibit potent antibacterial activity against MDR bacterial strains

Evaluation of bi-lateral co-infections and antibiotic resistance rates among COVID-19 patients

In addition to the pathogenesis of SARS-CoV-2, bacterial co-infection plays an essential role in the incidence and progression of SARS-CoV-2 infections by increasing the severity of infection, as well as increasing disease symptoms, death rate and antimicrobial resistance (AMR). The current study was conducted in a tertiary-care hospital in Lahore, Pakistan, among hospitalized COVID-19 patients to see the prevalence of bacterial co-infections and the AMR rates among different isolated bacteria. Clinical samples for the laboratory diagnosis were collected from 1165 hospitalized COVID-19 patients, of which 423 were found to be positive for various bacterial infections. Most of the isolated bacteria were Gram-negative rods (n = 366), followed by Gram-positive cocci (n = 57). A significant association (p 50% of COVID-19 patients were fever, fatigue, dyspnea and chest pain with a significant association (p < 0.05) in bacterial co-infected patients. The current study results showed a comparatively high prevalence of AMR, which may become a severe health-related issue in the future. Therefore, strict compliance of antibiotic usage and employment of antibiotic stewardship programs at every public or private institutional level are recommended

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Efficacy of platelet concentrates in pulpotomy – a systematic review

The main purpose of the present systematic review was to evaluate the efficacy of platelet concentrates in pulpotomy of human teeth. Our systematic search included Medline, Embase, CINAHL, PsycINFO, Scopus, key journals, and review articles; the date of the last search was July 30, 2017. We graded the methodological quality of the studies by Cochrane Risk of Bias tool. Four randomized controlled trails were included in the present systematic review. The number of study participants ranged from 28 to 50, with a mean of 45.5. The age of study participants ranged between 4 and 25 years. In three of the included studies, platelet-rich fibrin (autologous) was used and in one study lyophilized freeze-dried platelet (allogenic) was used as pulpotomy material. Calcium hydroxide and mineral trioxide aggregate were used in control groups. The quality assessment rated three studies as being of fair quality and one study as poor quality. Two of the included studies showed a 100% success of pulpotomy with platelet concentrates and two studies showed more than 80% of success, but the difference between control group and platelet concentrates group was not statistically significant. To conclude, the number of publications that met all inclusion criteria was found to be very limited and no significant difference was reported in the studies comparing platelet concentrates with other materials in pulpotomy. The present results point to the need for high-quality randomized controlled trials in further research

Influence of Cavity Size on the Survival of Single Surface Atraumatic Restorative Treatment Using Glass Ionomer Cement with or without Chlorhexidine Diacetate—A Randomized Trial

The purpose of the present study was to assess the influence of cavity size on the survival of conventional and CHX modified GIC in single surface primary molars receiving Atraumatic Restorative Treatment (ART). A randomized controlled trial with a split-mouth design was conducted on 90 children with symmetrical bilateral single surface carious lesions on primary molars. The teeth were randomly allotted to the conventional GIC group (group 1, n = 90) and CHX modified GIC group (group 2, n = 90). Both groups received atraumatic restorative treatment under rubber dam isolation. The cavity size was measured in terms of depth, mesiodistal, and buccolingual dimensions. The survival of ART restorations was measured after 6, 12, 18, and 24 months. The difference in proportion was tested using the Kruskal–Wallis H test, and survival curve estimation was carried out using the Kaplan–Meier method. The overall survival of all ART restorations was 83.3% at 24 months for the total sample. The survival of conventional GIC at 24 months was 83.9%, and for CHX-modified GIC was 82.7% (p &gt; 0.05). The collective overall success of 65.1% was seen in the cavity volume category of 10–29.9 mm3. CHX modified GIC showed high survival percentage (60%) with depth &gt;3 mm. To conclude, no significant difference was observed in the overall survival percentage of conventional and CHX modified GIC. Survival percentage was highest for cavities with a volume of 10–19.9 mm3

More General Weighted-Type Fractional Integral Inequalities via Chebyshev Functionals

The purpose of this research paper is first to propose the generalized weighted-type fractional integrals. Then, we investigate some novel inequalities for a class of differentiable functions related to Chebyshev’s functionals by utilizing the proposed modified weighted-type fractional integral incorporating another function in the kernel F(θ). For the weighted and extended Chebyshev’s functionals, we also propose weighted fractional integral inequalities. With specific choices of ϖ(θ) and F(θ) as stated in the literature, one may easily study certain new inequalities involving all other types of weighted fractional integrals related to Chebyshev’s functionals. Furthermore, the inequalities for all other type of fractional integrals associated with Chebyshev’s functionals with certain choices of ϖ(θ) and F(θ) are covered from the obtained generalized weighted-type fractional integral inequalities

Dynamics of Different Nonlinearities to the Perturbed Nonlinear Schrödinger Equation via Solitary Wave Solutions with Numerical Simulation

This paper investigates the solitary wave solutions for the perturbed nonlinear Schrödinger equation with six different nonlinearities with the essence of the generalized classical derivative, which is known as the beta derivative. The aforementioned nonlinearities are known as the Kerr law, power, dual power law, triple power law, quadratic–cubic law and anti-cubic law. The dark, bright, singular and combinations of these solutions are retrieved using an efficient, simple integration scheme. These solutions suggest that this method is more simple, straightforward and reliable compared to existing methods in the literature. The novelty of this paper is that the perturbed nonlinear Schrödinger equation is investigated in different nonlinear media using a novel derivative operator. Furthermore, the numerical simulation for certain solutions is also presented