RESULTS: The means of TMH without the contact lenses were 0.21 ± 0.06 mm and 0.20 ± 0.05 mm obtained from AS-OCT and Oculus K5M, respectively, and these measurements were not statistically significant (t (53) = 0.99, p = 0.33). No significant differences were observed in TMH compared to contact lenses (t (53) = 1.52, p = 0.13). Agreement between measurements obtained by both the instruments was assessed using Bland-Altman analysis. The limits of agreement were within clinically acceptable ranges (0.10 mm - 0.15 mm), with no evidence of significant bias (t = -0.32, r = 0.22). The results obtained with contact lenses were also not statistically significant (t (53) = 1.52, p < 0.05).
DISCUSSION: The present study compared tear meniscus height (TMH) measurements obtained from AS-OCT and Oculus K5M in subjects with and without contact lens wear. Both instruments showed good agreement, with AS-OCT consistently measuring slightly higher TMH values than Oculus K5M. The mean TMH values were similar to those of previous studies, indicating normal tear film in the subjects. Contact lens wear was found to reduce TMH slightly, but it returned to baseline after a short adaptation period. The Bland-Altman analysis confirmed good agreement between the two instruments, with most data points falling within the limits of agreement. These findings suggest that AS-OCT and Oculus K5M can be reliable tools for measuring TMH and can be used interchangeably for clinical practice.
CONCLUSION: AS-OCT and Oculus Keratograph® 5M showed comparable results in measuring TMH, suggesting potential interchangeability in clinical practice. Further validation in broader clinical settings and diverse subject groups may be warranted.
MATERIALS AND METHODS: A multi-step computational approach was employed, beginning with the virtual screening of 143 Erythrina alkaloid structures using molecular docking against the human AChE crystal structure. The binding affinities were compared with the known AChE inhibitor, galantamine. The top alkaloid, 8-oxoerymelanthine (128), was subjected to further analysis through molecular dynamics simulations, with the objective of evaluating its stability and interactions. In silico ADMET predictions were conducted to assess the pharmacokinetic properties. The applicability of Lipinski's Rule of Five was applied to evaluate oral drug-likeness.
RESULTS: 8-Oxoerymelanthine (128) exhibited the highest binding affinity and remarkable stability in molecular dynamics simulations. The toxicity predictions indicated a low risk of mutagenicity, hepatotoxicity, and cardiotoxicity. Pharmacokinetic assessments indicated good absorption, moderate blood-brain barrier penetration, and favorable metabolic and excretion profiles, supporting its potential as an orally active drug candidate.
CONCLUSION: 8-Oxoerythmelanthine (128) exhibits strong potential as an AChE inhibitor with a favorable balance of efficacy, safety, and pharmacokinetic properties. These results warrant further investigation in preclinical and clinical studies to validate its therapeutic potential and safety for Alzheimer's disease treatment.
MATERIALS AND METHODS: This study involves a total of 650 patients who were divided into two groups: the intervention group, which received care according to ERAS protocols, and the control group, which received standard postoperative care. Patients aged >18 years and scheduled for elective abdominal surgery were included in the study.
RESULTS: The mean age of patients in ERAS group were 56.4 ± 12.3 years, while in the standard care group 57.1 ± 11.8 years. Out of 650 patients, there were 339 male and 311 female. Patients were selected from different surgery departments. The ERAS group had lower 30-day readmission rates (6.2% vs. 15.4%), quicker mobilization (12.5 vs. 24.8 hours), and faster resumption of oral intake (8.6 vs. 18.2 hours). Pain levels were lower (VAS 3.1 vs. 5.8), and patient satisfaction was higher (89% vs. 74%) in the ERAS group, with all differences being statistically significant.
CONCLUSION: It is concluded that ERAS protocols significantly improve postoperative outcomes, including reducing complications, shortening hospital stays, and lowering readmission rates for patients undergoing elective abdominal surgery.
MATERIALS AND METHODS: A total of forty mandibular first molars having curved mesial roots of standardized length were subjected to instrumentation, utilizing both single-length and TCA techniques. Pre-weighed Eppendorf tubes were used to collect the extruded debris. The tubes underwent weighing to acquire the final weight of the dry debris. The initial weight was subtracted from the final weight to determine the weight of the extruded debris. The Shapiro-Wilk test was utilized to evaluate the data distribution. The Mann-Whitney U test was utilized to analyze continuous variables with a significance level of P ≤ 0.05.
RESULTS: Either of the techniques tested was associated with apical debris extrusion, but the TCA technique in a crown-down approach resulted in considerably less debris extrusion compared to the single-length technique.
CONCLUSION: The TCA technique in the crown-down approach demonstrated the least debris extrusion, suggesting the importance of selecting the appropriate technique in curved canal management.
MATERIALS AND METHODS: The association between TMD and age, gender, vertical condyle position, horizontal condyle position, and steepness of articular eminence in individuals with various malocclusions was examined using 30 CBCT images.
RESULTS: The asymptomatic group shared the concentric location of the condyle in their respective mandibular fossae, which is also a typical hallmark of Class II and Class III malocclusion on the left temporomandibular joint. Patients with TMD were more likely to be in the posterior condylar position. In all malocclusions and TMD cases, the condylar head's vertical position was mostly normal and slightly elevated. All malocclusions and TMD patients had moderate to severe articular eminence steepness. In individuals with TMD and malocclusions, the mesiodistal breadth of was considerable on the left side.
CONCLUSION: Future research should be done with a larger sample size and an emphasis on assessing how the condyle's location will change after therapy for patients with TMD.
MATERIALS AND METHODS: An in vitro model using synthetic bone blocks mimicking trabecular and cortical bone was used to simulate implant placement. The study involved 40 implants, divided into four groups based on bone type and density: Group A (low-density trabecular bone), Group B (high-density trabecular bone), Group C (low-density cortical bone), and Group D (high-density cortical bone). Primary stability was assessed using insertion torque values and resonance frequency analysis (RFA). Insertion torque was measured using a digital torque meter, and RFA was measured using an Osstell ISQ device.
RESULTS: Group D (high-density cortical bone) exhibited the highest insertion torque values (mean: 45 Ncm) and Implant Stability Quotient (ISQ) values (mean: 75), indicating superior primary stability. Group C (low-density cortical bone) showed moderate stability, with mean insertion torque values of 30 Ncm and ISQ values of 60. Group B (high-density trabecular bone) had lower stability, with mean insertion torque values of 25 Ncm and ISQ values of 55. Group A (low-density trabecular bone) demonstrated the least stability, with mean insertion torque values of 15 Ncm and ISQ values of 45.
CONCLUSION: The study concludes that cortical bone, especially high-density cortical bone, significantly contributes to primary implant stability compared to trabecular bone. The findings suggest that bone quality should be a major consideration during implant placement to ensure optimal primary stability and long-term success.
METHODS: A simple, 5-question online survey was conducted nationwide among registered Malaysian HPs, including doctors, nurses, assistant medical officers, and medical attendants.
RESULTS: A total of 529 HPs participated in the survey, with a median age of 35 years. Most had more than 5 years of working experience (74.7%) and worked in specialist hospitals (66.7%). Only 56.3% of HPs had heard of PAG services, and 43.7% were familiar with the HEADSS tool, with 60.2% using it in practice. Awareness was higher among doctors (61.4%), senior HPs (59.2%), and those in specialist hospitals (69.7%). Among doctors, both experience and workplace significantly impacted their awareness. Notably, 2% of doctors were unsure about which specialty was appropriate for referrals when managing acute abdomen in adolescents.
CONCLUSION: Overall, awareness of PAG services is low, with only 56.3% of HPs and 61.4% of doctors being familiar with the specialty. Management practices vary and lack standardization. We recommend implementing standardized training programs to improve the awareness and care for adolescent patients.
METHODS: An electronic search of literature was conducted in PubMed, Scopus, Web of Science, and Google Scholar in addition to a manual search in specialized journals up to May 2024. The eligibility criteria, data extraction, and evaluation of risk of bias were assessed by two independent authors. The risk of bias was evaluated in accordance with Modified CONSORT checklist items for pre-clinical in vitro studies on dental materials.
RESULTS: Out of 343 studies, thirty-seven fulfilled the inclusion criteria and were included in this review. Thirty studies reported a good antibacterial efficacy of Biodentine against E. faecalis. Biodentine was superior to or, at least, as efficacious as MTA, MTA Angelus, GIC, RMGIC, DiaRoot BioAggregate, NeoPutty, iRoot FS, MTA Repair HP, MTA Biorep, Well-Root PT, Activa, NeoMTA 2, Calcimol LC, TotalFill, and IRM. The findings were supported by studies with medium to high risk of bias (low quality).
CONCLUSIONS: Considering the limitations of this systematic review, there is accumulating evidence on the antibacterial activity of Biodentine against E. faecalis in context of endodontics. However, randomized clinical trials with well-designed and robust methodologies are required in order to provide information about its clinical behaviour.
METHODS: A case-control study was conducted among 317 caregivers of individuals with IDD (n = 168) and control (n = 149) groups, which involved the completion of the questionnaire. A closed-ended, validated self-designed questionnaire was distributed. The questionnaire included questions addressing participants' oral health knowledge and behavior. Convenience sampling was used to select the caregivers from centers associated with IDD by collecting data from nearby locations. Using SPSS® software Version 22 with a 0.05 level of significance data were analyzed. A Chi-square test and contingency-table analysis were performed on the data.
RESULTS: Caregivers for individuals with IDD in Jordan were less knowledgeable about different oral health aspects than control group (P value
DESIGN: Cross-sectional study.
SETTING: Three tertiary care hospitals in Kelantan, Malaysia, February-March 2023.
PARTICIPANTS: The study's inclusion criteria were nurses who were Malaysian citizens, working in shifts and possessing a minimum of 6 months of work experience. Nurses holding administrative positions and those unavailable during the study period were excluded from participation. A stratified proportionate random sampling method was employed, and a 100% response rate was achieved, with all 418 selected nurses participating in the study.
OUTCOME MEASURES: Nurses' perceptions of patient handoffs were assessed using the validated Hospital Patient Handoff Questionnaire. Predictors of these perceptions were identified through multiple linear regression analysis.
RESULTS: The study revealed an overall positive perception of handoffs, with a mean score of 3.5 on a 1-5 scale. Receiving formal in-service training on handoff practices (regression coefficient 0.089, 95% CI: 0.016 to 0.161) and expressing satisfaction with the handoff process (regression coefficient 0.330, 95% CI: 0.234 to 0.425) were positively associated with nurses' perceptions. Working in the paediatric department was associated with a lower perception of handoffs (regression coefficient -0.124, 95% CI: -0.195 to -0.053).
CONCLUSIONS: Formal in-service training, satisfaction and working in the paediatric department were significantly associated with nurses' perceptions of patient handoffs in Kelantan. These findings suggest the need for tailored interventions to improve handoff processes and enhance patient safety. Further research could explore the effectiveness of specific training programmes targeting these identified predictors.
DESIGN: Employing a qualitative methodology using a problem-driven political economy analysis approach.
SETTING: We are collecting data from a total of 12 focus group discussions (FGDs) conducted between July and September 2022 in three provinces-Lampung, Special Region of/Daerah Istimewa Yogyakarta and Bali, each chosen to represent a specific commodity: tobacco, sugar-sweetened beverages (SSBs) and alcoholic beverages-we explore the multifaceted dynamics of health tax policies.
PARTICIPANT: These FGDs involved a mean of 10 participants in each FGD, representing governmental institutions, non-governmental organisations and consumers.
RESULTS: Our findings reveal that health tax policies have the potential to contribute significantly to public health. Consumers understand tobacco's health risks, and cultural factors influence both tobacco and alcohol consumption. For SSBs, the consumers lack awareness of long-term health risks is concerning. Finally, bureaucratic complexiting and decentralised government hinder implementation for all three commodities.
CONCLUSION: Furthermore, this study underscores the importance of effective policy communication. It highlights the importance of earmarking health tax revenues for public health initiatives. It also reinforces the need to see health taxes as one intervention as part of a comprehensive public health approach including complementary non-fiscal measures like advertising restrictions and standardised packaging. Addressing these challenges is critical for realising the full potential of health tax policies.
DESIGN: Cross-sectional study.
SETTING: A self-administered online survey was carried out in five selected cities in the Fujian province of China between February 2022 and May 2022.
PARTICIPANT: PCPs working in the departments, such as Internal Gastroenterology and Hepatology, General Internal Medicine, Internal Medical Oncology Gastrointestinal Surgery or other clinical departments, have the chance to diagnose or treat patients with suspected gastric cancer.
MAIN OUTCOME MEASURES: Percentage of PCPs identifying gastric cancer patients either by undertaking an endoscopy at the primary hospital or by referring patients to an upper-level hospital.
RESULTS: A total of 1210 complete responses were received. Nearly half of responding PCPs (46.4%) only had less than 5 years of clinical experience, and the majority worked in suburban or rural regions (64.4%). Direct access to blood tests for cancer diagnosis (77.9%), X-ray (77.2%), CT (55.7%), ultrasound (85.3%), upper gastrointestinal endoscopy (54.4%) and colonoscopy (51.9%) was common. Of the respondents, 85.5% reported that they could get specialist advice for a suspected cancer patient within 48 hours in terms of investigations and 84.0% in terms of referral. Patients' waiting time to either conduct a test or have a result was mostly less than 1 week. In patients indicative of gastric cancer, a total of 1148 (94.8%) physicians were ready to investigate cancer either by sending patients to an endoscopy test (49.7%) or referring them to an upper-level hospital (45.1%).
CONCLUSIONS: Findings indicate that PCPs in five selected cities of Southeastern China have wide and rapid access to diagnostic tests and specialist advice. Furthermore, PCPs in this region seem to have a high level of readiness to consider investigation or referral for symptoms possibly indicative of gastric cancer.
DESIGN: Systematic review and meta-analysis.
DATA SOURCES: PubMed, Web of Science, Embase, the Cochrane Library, China National Knowledge Infrastructure and Wanfang were searched from inception to 11 June 2024.
ELIGIBILITY CRITERIA: Studies reported data on the prevalence and correlates of psychological distress were included. Review, letter, conference abstracts and articles not available in English and Chinese were excluded.
DATA EXTRACTION AND SYNTHESIS: Two researchers independently conducted literature screening, data extraction and bias risk assessment. Meta-analysis was employed to estimate the prevalence and correlates of psychological distress in patients with breast cancer. The Agency for Healthcare Research and Quality and the Newcastle-Ottawa Scale were used for quality assessment. Meta-analysis was performed by using the R V.4.1.1 software.
RESULTS: In total, 34 studies representing 13 828 patients with breast cancer were included in the study. Most of the studies were cross-sectional study (n=25, 73.53%%). The pooled prevalence of psychological distress was 50% (95% CI 42% to 58%, I2=98%). Results showed that psychological distress was positively correlated with younger age (z=0.13, 95% CI 0.07 to 0.20), having children (z=0.39, 95% CI 0.11 to 0.61), poor financial situation (z=0.12, 95% CI -0.03 to 0.26), short time since diagnosis (z=0.19, 95% CI 0.01 to 0.36), previous treatment (z=0.15, 95% CI 0.03 to 0.27), distant metastasis (z=0.31, 95% CI 0.07 to 0.52), chemotherapy (z=0.22, 95% CI 0.05 to 0.38), prior emotional status (z=0.40, 95% CI 0.29 to 0.50), body image damaged (z=0.10, 95% CI -0.01 to 0.21), negative coping (z=0.12, 95% CI -0.11 to 0.34), communication avoidance (z=0.32, 95% CI 0.24 to 0.39) and negatively correlated with married (z=-0.25, 95% CI 0.45 to -0.02), high education level (z=-0.19, 95% CI -0.40 to 0.05), having insured (z=-0.04, 95% CI -0.15 to 0.08), full employment (z=-0.40, 95% CI -0.61 to -0.14), time of completion of treatment (z=-0.12, 95% CI -0.30 to -0.06), surgery (z=-0.05, 95% CI -0.53 to 0.45), social support (z=-0.18, 95% CI -0.29 to -0.06), post-traumatic growth (z=-0.19, 95% CI -0.34 to -0.03), good physical conditions (z=-0.17, 95% CI -0.29 to -0.04), positive coping (z=-0.22, 95% CI -0.53 to 0.15).
CONCLUSION: Our findings indicated that the prevalence of psychological distress in patients with breast cancers was 50% and 21 correlates of psychological distress. Screening and evidence-based interventions are urgent and essential to address this public concern and promote the health of patients with breast cancer.
PROSPERO REGISTRATION NUMBER: CRD42023397109.
METHODS: In this multicentre RCT conducted between September 2020 and March 2022, patients aged 13 years and older with perforated appendicitis undergoing open appendicectomy were randomly assigned to receive peritoneal and wound lavage with either super-oxidized solution or normal saline. The primary outcome was surgical-site infection within 30 days after surgery. Randomization was computer-generated, with allocation concealment by opaque, sequentially numbered, sealed envelope. The patients, surgeons, outcome assessors and statisticians performing the analysis were blinded to treatment assigned.
RESULTS: A total of 102 consecutive patients (51 in the super-oxidized solution group and 51 in the normal saline group) were randomized and included in the intention-to-treat analysis. The super-oxidized solution group showed a significant reduction in overall surgical-site infection (8 (15.6%) versus 19 (37.2%); relative risk (RR) 0.42; 95% c.i. 0.20 to 0.87; P = 0.014), and superficial surgical-site infection (5 (9.8%) versus 18 (35.3%); RR 0.28; 95% c.i. 0.11 to 0.69; P = 0.002), with a number-needed-to-treat of four patients. There were no adverse events in either group.
CONCLUSIONS: Peritoneal and wound lavage with super-oxidized solution is superior to normal saline in preventing surgical-site infection after open appendicectomy for perforated appendicitis.
TRIAL REGISTRATION: ClinicalTrial.gov Identifier: NCT04512196.