Bonded amalgam as a fissure sealant in low-income setting: A randomised controlled trial

Objectives: To compare one year retention rate of bonded amalgam sealants (BAS) with that of conventional resin-based sealant (RBS). Methods: It was a parallel group, equivalence, randomised controlled trial done during March 2018 to December 2019 at the dental clinics of Dow University of Health Sciences, and the Jinnah Sind Medical University, Karachi, Pakistan on children aged 12-16 years, who were randomly assigned to one of the two treatment groups (BAS vs. RBS). Complete retention of the sealant at one year follow-up was labeled as success. Multi-level mixed effect logistic regression model was employed. Study was registered at www.clinicaltrials.gov # NCT NCT03130725. Results: There were 137 teeth (23 subjects) in the BAS and 128 teeth (15 subjects) in the RBS group that were evaluated for sealant retention at 12 months follow-up. Among the BAS group, 100/137 (73%) sealants were completely retained whereas 110/128 (86%) were fully retained in the RBS group. Nearly, 22/137 (16%) BAS and 10/128 (7.8%) RBS were completely dislodged. In multivariable analysis, subject age \u3e15 years and male gender were found to be significantly associated with the dislodgement of sealants. Conclusions: At 12 months follow-up, the retention of bonded amalgam sealant (BAS) was significantly lower than that of the resin-based sealant (RBS)

Does concurrent breastfeeding alongside the introduction of solid food prevent the development of food allergy?

The timing of introduction of solid food on the subsequent development of food allergy is under debate and the role of concurrent breastfeeding is unclear. The aim of the present study was to investigate the role of solid food introduction whilst concurrently breastfeeding on food allergy outcome, with a specific focus on cows’ milk allergy. Prospectively collected infant feeding data from a birth cohort were analysed. Participants with histories suggestive of food allergy underwent diagnostic food challenges. Children with food allergy were matched to control participants for age and sex. Mann–Whitney U tests, χ2, Fisher exact tests and logistic regression calculations were undertaken. A total of thirty-nine food-allergic children and seventy-eight matched controls were identified, including twenty-two cows’ milk-allergic children and forty-four matched controls. The control group introduced solid food earlier than the food-allergic group (P < 0·05). There was no effect of concurrent breastfeeding alongside cows’ milk introduction or other food allergens on the development of food allergy. Due to small numbers, it was not possible to explore differences for food allergy phenotype. We have therefore found no evidence that introducing solids, or food allergens, whilst breastfeeding has an allergy-preventative effect; however, the results should be interpreted with caution due to sample size. Recommendations regarding infant feeding and food allergy should be carefully considered. Although breastfeeding should be promoted for many health reasons, larger studies looking at the introduction of food allergens on the development of food allergy are needed to make a final conclusion

Pathophysiological characterization of asthma transitions across adolescence

BACKGROUND: Adolescence is a period of change, which coincides with disease remission in a significant proportion of subjects with childhood asthma. There is incomplete understanding of the changing characteristics underlying different adolescent asthma transitions. We undertook pathophysiological characterization of transitional adolescent asthma phenotypes in a longitudinal birth cohort.METHODS: The Isle of Wight Birth Cohort (N = 1456) was reviewed at 1, 2, 4, 10 and 18-years. Characterization included questionnaires, skin tests, spirometry, exhaled nitric oxide, bronchial challenge and (in a subset of 100 at 18-years) induced sputum. Asthma groups were "never asthma" (no asthma since birth), "persistent asthma" (asthma at age 10 and 18), "remission asthma" (asthma at age 10 but not at 18) and "adolescent-onset asthma" (asthma at age 18 but not at age 10).RESULTS: Participants whose asthma remitted during adolescence had lower bronchial reactivity (odds ratio (OR) 0.30; CI 0.10 -0.90; p = 0.03) at age 10 plus greater improvement in lung function (forced expiratory flow 25-75% gain: 1.7 L; 1.0-2.9; p = 0.04) compared to persistent asthma by age 18. Male sex (0.3; 0.1-0.7; p &lt; 0.01) and lower acetaminophen use (0.4; 0.2-0.8; p &lt; 0.01) independently favoured asthma remission, when compared to persistent asthma. Asthma remission had a lower total sputum cell count compared to never asthma (31.5 [25-75 centiles] 12.9-40.4) vs. 47.0 (19.5-181.3); p = 0.03). Sputum examination in adolescent-onset asthma showed eosinophilic airway inflammation (3.0%, 0.7-6.6), not seen in persistent asthma (1.0%, 0-3.9), while remission group had the lowest sputum eosinophil count (0.3%, 0-1.4) and lowest eosinophils/neutrophils ratio of 0.0 (Interquartile range: 0.1).CONCLUSION: Asthma remission during adolescence is associated with lower initial BHR and greater gain in small airways function, while adolescent-onset asthma is primarily eosinophilic.</p

Memory and cognitive flexibility in physical therapy students of Karachi

Memory allows us to remember the skills that we have learnt and retrieve valuable information stored in the brain. Physical therapy is a multidimensional profession which demands efficient cognitive flexibility and decision-making skills with an excellent memory to help the therapist to multi-task

Very low prevalence of IgE mediated wheat allergy and high levels of cross-sensitisation between grass and wheat in a UK birth cohort

BackgroundPatients often report adverse reactions to wheat. Interpretation of sensitization to wheat pollen and flour with/without sensitization to grass pollen is a clinical problem.AimWe set out to determine the prevalence of wheat allergy in a birth cohort (10/11 year olds) and investigate the usefulness of performing skin prick tests (SPT), specific IgE tests and component resolved diagnostics to wheat pollen and flour.MethodsThe Food Allergy and Intolerance Research (FAIR) birth cohort included babies born on the Isle of Wight (UK) between September 2001–August 2002 (n = 969). Children were followed up at 1, 2, 3 and 10/11 years. 588 children had SPTs to wheat pollen and grass during the 10 year follow-up. 294 children underwent further SPT to wheat flour and 246 had specific IgE testing to wheat and grass.ResultsEight children underwent oral food challenges (OFC). We diagnosed 0.48 % (4/827; 95 % CI 0–1 %) children with wheat allergy based on OFC. 16.3 % (96/588) were sensitized to grass pollen, 13.4 % (79/588) to wheat pollen; 78 % (75/96) sensitized to both. Only one child was sensitized to wheat flour and wheat pollen, but not grass pollen. For specific IgE, 15.0 % (37/246) and 36.2 % (89/246) were sensitized to wheat and grass pollen, with 40.5 % (36/89) sensitized to both. Of the 37 children sensitized to wheat, 3 (8.1 %) were sensitized to omega 5 gliadin, 1 (2.7 %) to wheat lipid transfer protein and 1 to wheat gliadin.ConclusionClinicians should be aware of the high level of cross-sensitization when performing tests to wheat and grass pollen i.e. sensitisation to wheat specific IgE and wheat pollen SPT should be assessed in the presence of grass pollen SPT and/or specific IgE

DNA methylation at birth is associated with lung function development until age 26 years

Little is known about whether DNA methylation (DNAm) of cytosine-phosphate-guanine (CpG) sites at birth predicts patterns of lung function development. We used heel prick DNAm from the F1-generation of Isle of Wight birth cohort (IOWBC-F1) for discovery of CpGs associated with lung function trajectories (forced expiratory volume in 1 s, forced vital capacity, their ratio, and forced expiratory flow at 25-75% of forced vital capacity) over the first 26 years, stratified by sex. We replicated the findings in the Avon Longitudinal Study of Parents and Children (ALSPAC) using cord blood DNAm. Epigenome-wide screening was applied to identify CpGs associated with lung function trajectories in 396 boys and 390 girls of IOWBC-F1. Replication in ALSPAC focussed on lung function at ages 8, 15 and 24 years. Statistically significantly replicated CpGs were investigated for consistency in direction of association between cohorts, stability of DNAm over time in IOWBC-F1, relevant biological processes and for association with gene expression (n=161) in IOWBC F2-generation (IOWBC-F2). Differential DNAm of eight CpGs on genes GLUL, MYCN, HLX, LHX1, COBL, COL18A1, STRA6, and WNT11 involved in developmental processes, were significantly associated with lung function in the same direction in IOWBC-F1 and ALSPAC, and showed stable patterns at birth, aged 10 and 18 years between high and low lung function trajectories in IOWBC-F1. CpGs on LHX1 and COL18A1 were linked to gene expression in IOWBC-F2. In two large cohorts, novel DNAm at birth were associated with patterns of lung function in adolescence and early adulthood providing possible targets for preventative interventions against adverse pulmonary function development.</p

Association of Maternal DNA Methylation and Offspring Birthweight

This study aims to evaluate the association of maternal DNA methylation (DNAm) during pregnancy and offspring birthweight. One hundred twenty-two newborn-mother dyads from the Isle of Wight (IOW) cohort were studied to identify differentially methylated cytosine-phosphate-guanine sites (CpGs) in maternal blood associated with offspring birthweight. Peripheral blood samples were drawn from mothers at 22-38 weeks of pregnancy for epigenome-wide DNAm assessment using the Illumina Infinium HumanMethylation450K array. Candidate CpGs were identified using a course of 100 repetitions of a training and testing process with robust regressions. CpGs were considered informative if they showed statistical significance in at least 80% of training and testing samples. Linear mixed models adjusting for covariates were applied to further assess the selected CpGs. The Swedish Born Into Life cohort was used to replicate our findings (n = 33). Eight candidate CpGs corresponding to the genesLMF1,KIF9,KLHL18,DAB1,VAX2,CD207,SCT,SCYL2,DEPDC4,NECAP1, andSFRS3in mothers were identified as statistically significantly associated with their children's birthweight in the IOW cohort and confirmed by linear mixed models after adjusting for covariates. Of these, in the replication cohort, three CpGs (cg01816814, cg23153661, and cg17722033 withpvalues = 0.06, 0.175, and 0.166, respectively) associated with four genes (LMF1,VAX2,CD207, andNECAP1) were marginally significant. Biological pathway analyses of three of the genes revealed cellular processes such as endocytosis (possibly sustaining an adequate maternal-fetal interface) and metabolic processes such as regulation of lipoprotein lipase activity (involved in providing substrates for the developing fetus). Our results contribute to an epigenetic understanding of maternal involvement in offspring birthweight. Measuring DNAm levels of maternal CpGs may in the future serve as a diagnostic tool recognizing mothers at risk for pregnancies ending with altered birthweights.Peer reviewe