A Comparative Study of the Efficiency of two Different Glass Ionomer Using ART Technique in a Group of Egyptian Children with Autistic Spectrum Disorder

Aim: The aim of the study was to evaluate and compare the effect of conventional glass ionomer cement and Nano-glass ionomer using atraumatic restorative technique (ART) in a group of Egyptian autistic children.Materials and Methods: Thirty autistic patients had cavitated lower first primary molars (class I only) were included in this study. According to the type of restorative material used, the children were classified into 2 groups: (Group I) their teeth were restored with conventional glass ionomer, (Group II) their teeth were restored with Nano-glass ionomer (ketac N 100). All children were checked clinically, radio graphically and for bacterial count evaluation at baseline (before treatment) and after 1 week, 2 weeks, 1 month, 3 months and 6 months.Results: After 6 months, group I showed statistically significant higher prevalence of pain, food stagnation, restoration defects and widening of lamina dura than group II while for bacterial count evaluation, the microbiological assay results show there was no statistically significant difference between the two groups.Conclusion: The results indicate that Nano-glass ionomer can be considered a successful alternative restorative material for ART technique with promising results in treatment of children with autistic spectrum disorder.</p

The role of antioxidants and zinc in minimal hepatic encephalopathy: a randomized trial

Background: Minimal hepatic encephalopathy (MHE) has a far-reaching impact on quality and function ability in daily life and may progress to overt hepatic encephalopathy. There is a synergistic effect between systemic oxidative stress and ammonia that is implicated in the pathogenesis of hepatic encephalopathy. The aim of this study is to investigate the effectiveness of oral supplementation of antioxidants and zinc gluconate on MHE versus lactulose. Methods: Our study included 58 patients with cirrhosis diagnosed as having MHE by neuropsychometric tests, including number connection test part A (NCT-A), digit symbol test (DST) and block design tests (BDTs). Patients were randomized to receive 175 mg zinc gluconate, 50,000 IU vitamin A, 500 mg vitamin C and 100 mg vitamin E once daily plus lactulose, dose 30–60 ml/day for 3 months [group A ( n = 31)] or initiated and maintained on lactulose dose 30–60 ml/day for 3 months [group B ( n = 27)]. Neuropsychometric tests and laboratory investigations were repeated after 3 months of therapy. Results: Compared with the baseline neuropsychometric tests, a significant improvement was reported in patients with MHE after 3 months of antioxidant and zinc therapy (group A) versus patients with lactulose therapy (group B) (NCT-A, p < 0.001; DST, p = 0.006; BDT, p < 0.001). Antioxidant and zinc supplementation significantly decreased arterial ammonia level, alanine aminotransferase (ALT), aspartate aminotransferase (AST) ( p < 0.001) and improved Child–Pugh score in MHE after 3 months of therapy ( p = 0.024). Conclusion: Antioxidant and zinc supplementation can improve MHE in patients with liver cirrhosis

A risk score to predict 30-day hospital readmission rate in cirrhotic patients with spontaneous bacterial peritonitis

Abstract Background and aim There is lack of 30-day hospital readmission prediction score in patients with liver cirrhosis and SBP. The aim of this study is to recognize factors capable of predicting 30-day readmission and to develop a readmission risk score in patients with SBP. Methods This study prospectively examined the 30-day hospital readmission for patients previously discharged with a diagnosis of SBP. Based on index hospitalization variables, a multivariable logistic regression model was implemented to recognize predictors of patient hospital readmission within 30 days. Consequently, Mousa readmission risk score was established to predict 30-day hospital readmission. Results Of 475 patients hospitalized with SBP, 400 patients were included in this study. The 30-day readmission rate was 26.5%, with 16.03% of patients readmitted with SBP. Age ≥ 60, MELD > 15, serum bilirubin > 1.5 mg/dL, creatinine > 1.2 mg/dL, INR > 1.4, albumin < 2.5 g/dL, platelets count ≤ 74 (103/dL) were found to be independent predictors of 30-day readmission. Incorporating these predictors, Mousa readmission score was established to predict 30-day patient readmissions. ROC curve analysis demonstrated that at a cutoff value ≥ 4, Mousa score had optimum discriminative power for predicting the readmission in SBP with sensitivity 90.6% and specificity 92.9%. However, at cutoff value ≥ 6 the sensitivity and specificity were 77.4% and 99.7%, respectively, while a cutoff value ≥ 2 had sensitivity of 99.1% and specificity of 31.6%. Conclusions The 30-day readmission rate of SBP was 25.6%. With the suggested simple risk assessment Mousa score, patients at high risk for early readmission can be easily identified so as to possibly prevent poorer outcomes