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Comparison Comparison of Isotonic Versus Hypotonic Fluids in Neonates on Maintenance Fluid Therapy
No full textIntroduction:
In neonates, the use of hypotonic fluids is a widely accepted practice to maintain hydration and electrolyte balance, particularly after surgery. However, this approach can increase the risk of hyponatremia due to the lower sodium content in hypotonic solutions compared to blood plasma. This makes neonates more vulnerable to sodium imbalances if not properly monitored. While hypotonic fluids are commonly used, there is growing consideration of isotonic alternatives to reduce the risk of electrolyte disturbances and improve safety in neonatal care.
To evaluate and compare the outcomes of using isotonic versus hypotonic fluids in neonates receiving maintenance fluid therapy following surgery.
Study place and duration: Department of Pediatric Surgery, Holy Family Hospital, Rawalpindi from January 2023 to December 2023.
Material and Methods: Total 84 cases were enrolled in the study who underwent surgery and admitted in neonatal intensive care unit. Infants were randomly divided in two groups. Group I was given isotonic/normal saline with 5% dextrose in 0.9% saline. Group H was given hypotonic saline with 5% dextrose in 0.45% saline. Neonates were followed up and hyponatremia was noted. Data analysis will be done by using SPSS software version 25.0.
Results: In Isotonic saline solution, the mean age of neonates was 6.21 ± 6.19 days. In Hypotonic saline solution, the mean age of neonates was 3.84 ± 3.50 days. In Isotonic saline solution, hyponatremia was developed in 2 (4.8%) cases, hypernatremia in 9 (21.4%) cases, while 31 (73.8%) neonates maintained normal serum sodium level. In Hypotonic saline solution, hyponatremia was developed in 11 (26.2%) cases, hypernatremia in 0 (0%) cases, while 31 (73.8%) neonates maintained normal serum sodium level. The difference in both groups was found to be significant (p<0.05).
Conclusion: The risk of hyponatremia is higher with hypotonic saline solution when used as maintenance fluid after surgery in pediatric population
Correlation between the Thickness and Anterior-Posterior Width of the Masseter Muscle in Ultrasonography with the Intermolar Width in Maxilla and Mandible
Get PDFObjective(s): The interplay between masticatory muscle function and dental arch size holds considerable significance within the discipline of orthodontics. This research endeavored to quantify masseter muscle dimensions via ultrasonography (USG) and subsequently analyze their correlative relationship with dental arch width. Methods: 45 participants were enrolled in this cross sectional study, stratified by gender and age cohorts. Bilateral USG assessments, utilizing a 7.5 MHz linear transducer, were conducted to quantify masseter muscle thickness and anterior-posterior (AP) width during both relaxed and clenched states. Intermolar width was determined through direct measurement with a metal caliper on dental casts of the maxillary and mandibular arches. Independent samples t-tests were employed to analyze mean differences between male and female subjects. The association between masseter muscle dimensions (thickness and width) and intermolar width was evaluated using Spearman's rank correlation coefficient and Pearson's correlation coefficient, as appropriate at p<0.05. Results: The study cohort comprised 20 females and 25 males within the age range of 16 to 30 years. Statistically significant sexual dimorphism was observed, with males demonstrating substantially greater masseter muscle thickness and AP width compared to females in both relaxed and clenched states (p < 0.001). Consistent with expectations, males demonstrated statistically significant greater intermolar widths in both the maxilla and mandible (p < 0.001). Across the entire study population, a statistically significant positive correlation was identified between masseter muscle thickness and intermolar width (p < 0.05). Specifically, individuals exhibiting larger masseter muscle dimensions presented with correspondingly increased intermolar widths in both the maxillary and mandibular arches. However, when these variables were stratified by gender or age group, no statistically significant correlations were observed (p > 0.05).
Conclusion:USG is validated as a safe and reproducible technique for the objective measurement of masseter muscle thickness
Observational Study on the Safety and Efficacy of Rituximab in Multiple Sclerosis: Insights from North-Eastern Iran: Rituximab Efficacy and Safety in MS: Iran
No full textMultiple sclerosis (MS) is a chronic autoimmune and inflammatory disease that affects young people and causes demyelination and axon loss in the central nervous system. According to several studies, rituximab (RTX) reduces inflammation and relapse in patients with relapsing-remitting MS. This study aimed to evaluate the efficacy and safety of RTX in patients suffering from MS. MS patients were treated in the comprehensive MS clinic of Ghaem Hospital, Mashhad, Iran, and RTX administration was approved for them (1000 mg). Before initiating the study, demographic characteristics (e.g., age, gender, and type of MS disease), clinical variables (e.g., annual relapse rate [ARR] in the year before the intervention, Expanded Disability Status Scale (EDSS) score, and magnetic resonance imaging [MRI] findings), laboratory variables (e.g., complete blood count [CBC], liver and kidney function tests) for the patients were recorded. After the intervention, the variables were checked and re-recorded, and the patients were followed up at 6 and 12 months. In total, 50 patients with relapsing-remitting MS (RRMS), primary progressive MS (PPMS), or secondary progressive MS (SPMS) with mean age and treatment duration of 37.60±8.91 and 6.72±5.28 years, respectively, were included in the study. The results showed no significant difference among the three time periods regarding the mean disability level (P=0.73). Moreover, the mean ARR decreased significantly after the intervention (P=0.007). This study showed that RTX administration effectively reduces the ARR, and no significant safety issues were recorded. However, the results of this study could not prove RTX's efficacy in preventing confirmed disability progression
Evaluation of Genistein’s Cytotoxic and Apoptotic Effects on Human Foreskin Fibroblasts: A Molecular and Biochemical Analysis: Effects of Genistein on Fibroblast cells
No full textGenistein, a naturally occurring isoflavone in soybeans, has gained attention for its phytoestrogenic and antioxidant properties. Its role in endocrine modulation, oxidative stress regulation, and apoptosis suggests therapeutic potential in cancer and metabolic disorders. Foreskin fibroblasts serve as a model for studying genistein’s effects on cell proliferation, oxidative stress, and cytotoxicity. This study examines genistein’s influence on gene expression related to cell growth and stress responses, offering insights into its therapeutic or adverse effects. Human foreskin samples from seven donors (6–12 years old) were used. Fibroblasts were isolated via collagenase and trypsin digestion and cultured in DMEM with 10% FBS. Cells were treated with genistein (20–100 µM), and viability was assessed using MTT assays. Antioxidant enzyme activities (SOD, GPx, CAT) were quantified spectrophotometrically. Gene expression of Bax, Bcl-2, IGF-1, and Casp3 was analyzed via real-time PCR. Data were evaluated using t-tests and ANOVA, with p<0.05 considered significant. Genistein induced dose- and time-dependent cytotoxicity, significantly reducing cell survival above 40 µM. IC50 values decreased over time, confirming enhanced cytotoxicity. Enzyme activity assays showed reduced CAT, SOD, and GPx levels. Gene analysis revealed upregulation of pro-apoptotic markers (BAX, Casp3) and downregulation of anti-apoptotic genes (Bcl-2, IGF-1), with a BAX/Bcl-2 ratio exceeding one, indicating apoptosis. These findings highlight genistein’s potential as a therapeutic agent via oxidative stress modulation and apoptosis induction. This study confirms genistein’s cytotoxic effects on fibroblast cells through oxidative stress and apoptosis. Further research is needed to clarify its molecular mechanisms and optimize therapeutic applications
Management of Cracked and Weakened Endodontically Treated Teeth Using Fiber-reinforced Composites: A Case Series
Get PDFRestoring endodontically treated teeth (ETT) that exhibit cracks, enlarged roots, or weakened root walls is a frequent challenge in dental practice. The present study describes three cases in which contemporary restorative techniques were employed and suggests that applying Ribbond tape (RT) to ETT can improve fracture resistance and better prevent the propagation of cracks compared with traditional methods. Although extensive in vitro research has been conducted on fiber-reinforced composites, studies evaluating the clinical use and durability of fiber-reinforced composites to restore ETT are limited. This report strictly adhered to the case report (CARE) guidelines, and the treatments were initiated only after signed informed consents were obtained from the patients. Therefore, the old restorations were removed from the teeth that required intervention and composite resin core build-up was created, followed by endodontic treatments or retreatment. Subsequently, the endodontic accesses were reinforced with RT. The protective restorations were performed and bonded. The two-year follow-ups showed that the patients had complete remission of signs and symptoms, and they remain under monitoring. The study emphasizes the importance of internal reinforcement of ETT and strengthening weakened walls with a resin core build-up reinforced with fibers like RT. This approach enhances mechanical retention, inhibit fracture propagation, and establish a strong chemical bond between RT and resin. It is suggested to be a promising strategy for increasing the longevity and strength of the teeth, providing a conservative and effective alternative to traditional methods
Vital Pulp Therapy: Evidence-Based Techniques and Outcomes
Get PDFVital pulp therapy (VPT) comprises a range of conservative treatment modalities aimed at preserving the vitality of the compromised dental pulp in primary and permanent teeth. This PubMed-based review comprehensively evaluates seven distinct VPT techniques; including their historical development, broad definitions, clinical protocols and treatment outcomes as evidenced by systematic reviews and meta-analyses. The VPT modalities covered in this review include stepwise excavation, indirect pulp capping, direct pulp capping, miniature pulpotomy, partial pulpotomy, full pulpotomy and partial pulpectomy. Stepwise excavation, as a minimally-invasive option, has demonstrated effectiveness in reducing the risk of pulp exposure, particularly in permanent teeth. Clinical outcomes of indirect and direct pulp capping are promising; specifically with the application of advanced calcium silicate cements. Miniature and partial pulpotomies emphasize the importance of precise definitions and standardised protocols due to their subtle differences. Full pulpotomy has emerged as a viable alternative to root canal treatment, achieving comparable success rates in managing irreversible pulpitis. While partial pulpectomy remains the most invasive approach, it has shown potential in managing complex cases, such as root resorption, through selective tissue preservation. Despite advancements in biomaterials and technique standardisation, challenges remain, including variability in clinical protocols, limited high-quality evidence, and the need for long-term studies to better evaluate anticipated outcomes. Nevertheless, emerging biotechnologies hold promise for enhancing the precision and predictability of VPT procedures in the future
Correlation between Electrodiagnostic Findings and Cerebrospinal Fluid Changes in Children with Guillain-Barre syndrome
Get PDFObjectivesGuillain-Barré syndrome (GBS) involves the peripheral nervous system developed by infections or immune conditions. Cerebrospinal fluid (CSF) analysis and electrodiagnostic tests are essential diagnostic methods for GBS. However, limited data are available on how the findings from these methods relate to each other. This study aimed to evaluate changes in CSF analysis and electrodiagnostic tests in pediatrics with GBS.Materials & MethodsThe present study retrospectively evaluated electrodiagnostic tests and CSF changes in pediatrics with GBS who were admitted to Tabriz Hospital, Iran, from 2010 to 2020 due to CBS. Patients’ data, including age, gender, CSF analysis, and electrodiagnostic test results, were recorded from the patients’ files. Electrodiagnostic data included pace and amplitude of tibial, median, peroneal, sural, ulnar nerves, nerve conduction velocity (NCV), F-wave, and motor unit action potential (MUAP). The significance level was considered less than 0.05.ResultsThe mean age of patients was 4.83±2.72 years, and 54.6% were boys. The most common type of GBS involvement was demyelinating type. No gender differences were found between involved nerves unless the ulnar nerve was significantly more involved in girls (P-value: 0.012). The obtained findings indicated no significant relationship between electrodiagnostic tests and CSF protein (P-value: 0.439).ConclusionNo association was observed between electrodiagnostic results and CSF changes in pediatrics with GBS
Analyzing Morphometrics of Sella Turcica, Foramen Magnum and Mastoid Processes Using Head and Neck Computed Tomography for Sex Determination in Egyptian Adults
Get PDFBackground: Recognition of unknown individuals is an essential element in forensics. This study aims to analyze the morphometrics of the sella turcica, foramen magnum (FM), and mastoid process in adult sex determination. In addition, to identify from the previously mentioned parts which is the most efficient single parameter in adult sex determination. In addition, we look forward to correlating the significant efficacy of the previously mentioned parts in sex determination using two or all of them together compared to using one bony part alone.Methods: In this cross-sectional study, 60 Egyptian adults (30 men and 30 women) with multislice computed tomography (MSCT) bone window scans of the head and neck obtained for different purposes were included to obtain cranial measurements of the sella turcica, FM, and mastoid triangle area.Results: The Sella turcica anterior-posterior (A-P) diameter of the adult male cases had a Mean±SD of 14.015±2.15 mm compared to 12.851±1.904 mm among adult female cases. The mean maximum FM width (FMW) of men was 32.183±2.126 mm, while that of women was 30.169±2.530 mm. The men’s FM area (FMA) had a Mean±SD of 885.606±124.665 mm2; In women, the Mean±SD were 784.179±140.997 mm2. The mastoid triangle area’s Mean±SD were 778.559±87.218 mm2 among men compared to a mean of 645.215±88.733 mm2 among women. Conclusion: This study determined that sella turcica A-P diameter, mastoid area, FMW, FMA, the maximum length of the right and left occipital condyle (LROC), and length of the left occipital condyle (LLOC) showed significantly higher measures in adult Egyptian males. The best single parameter determining the adult sex was the mastoid triangle area with a cut-off level of 647.22 mm2. The sella turcica A-P diameter, LLOC, and mastoid triangle area represent the best combination of all measured parameters for determining sex in adults. A predictive formula was performed using the best combination in adult cases with an accuracy of 87% in sex determination
Photobiomodulation Therapy in Improving Quality of Life in Kindler Syndrome: A Case Study: PBM therapy for trismus
No full textIntroduction: Kindler syndrome (KS) is a rare genetic disorder characterized by skin fragility, acral blister formation, diffuse cutaneous atrophy, photosensitivity, palmoplantar hyperkeratosis, pseudosyndactyly, and alopecia. Oral manifestations include limited mouth opening, which adversely affects oral hygiene, chewing, and swallowing, significantly impacting the quality of life of affected individuals.Methods: A 26-year-old male with KS was referred for the management of reduced mouth opening, presenting with an interincisal distance of 19 mm. This was a critical concern for facilitating prosthetic rehabilitation. The patient underwent Photobiomodulation (PBM) therapy as a non-invasive treatment modality aimed at improving trismus.Results: Following PBM therapy, the patient’s mouth opening improved significantly from 19 mm to 23 mm. This enhancement allowed for the initiation of prosthetic rehabilitation.Conclusion: PBM therapy is a promising treatment for managing trismus in KS by breaking down abnormal collagen deposits and reducing collagen synthesis, effectively addressing the underlying pathology. It offers significant improvements in mouth opening, which can enhance oral hygiene, nutritional intake, and overall quality of life. This non-invasive approach provides a viable option for patients with KS who require prosthetic rehabilitation
Therapeutic Effects of Low-Level Laser Therapy on Rat Spinal Cord Injury: Analysis of Inflammatory Markers and Testicular Function: Therapeutic effects of low-level laser therapy on rat spinal cord injury
No full textIntroduction: Spinal cord injury (SCI) is a severe condition often leading to lasting neurological impairment and associated reproductive health issues in males. The aim of this study was to investigate the therapeutic potential of photobiomodulation therapy (PBMT) during the inflammatory phase of SCI to prevent oxidative damage, reduce inflammation, and mitigate potential damage to testicular function.Methods: Eighteen male rats were randomly divided into three groups: Group A (laminectomy only), group B (contusion), and group C (contusion + PBMT). Thirty minutes post-injury, group C received PBMT for two weeks. Histological and stereological analysis was evaluated using the hematoxylin and eosin test (H&E). ELISA and real-time PCR were performed for eight weekspost-SCI to assess testosterone and inflammatory and apoptotic changes. Statistical analysis was performed using SPSS with one-way ANOVA and Tukey’s post hoc test, and statistical significance was set at P < 0.05.
Results: The SCI group exhibited significant reductions in sperm count (mean ± SD: 14.2 ± 86.1), motility (34.8 ± 72.8), and viability (26.12 ± 43.9), with increased levels of inflammatory markers (IL-1 β: 4.4 ± 71.6, TNF-α: 3.14 ± 66) and damage to testicular structure. In contrast, animals treated with PBMT showed significant improvements in sperm parameters (sperm count: 48 ± 34, motility: 57.2 ± 18.5, viability: 52 .3 ± 88.2) and a marked reduction in inflammation (IL-1 β: 3.09 ± 14.2, TNF-α: 2.67 ± 74.1) compared to untreated SCI animals (P < 0.001). Additionally,PBMT-treated animals demonstrated significant improvements in testosterone levels (1.57 ± 44.8) and a reversal of testicular cell loss (P < 0.001).Conclusion: These findings suggest that PBMT mitigates the negative effects of SCI on testicular tissue by reducing inflammation and preserving cellular integrity, thus supporting its use as a dual therapeutic approach to aid neurological recovery and maintain reproductive health