Addressing the effectiveness of health literacy programs within the Gulf Corporation Council: an integrative review.

Health literacy is an increasingly required need to help individuals, families and communities manage their health and health conditions. It is linked with better self-adherence to treatments, use of resources, access to care and overall reduced costs in healthcare. In the Gulf Cooperation Council (GCC), which comprises Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates, various health literacy programs are implemented across states to address people's unique and complex healthcare needs. This article aims to examine the current literature and assess the factors that influence the outcomes of health literacy programs within the GCC. An integrative review methodology has been conducted to pursue a comprehensive understanding of health literacy interventions in the GCC. This investigative approach was shaped by Whittemore and Knafl's framework (2005), which includes problem identification, literature search, data evaluation, data analysis and presentation. The literature on the effectiveness of health literacy interventions and the factors that shape them are notably limited worldwide and within the GCC region. This integrative review addresses this knowledge gap and highlights the significance of key themes such as sessions, evaluation and improvement in shaping health literacy outcomes within the GCC region. Through this integrative review, the three main themes of sessions, evaluation and improvement were identified as influencing the outcomes of health literacy programs within the GCC.

Individual differences in intracortical inhibition predict motor-inhibitory performance.

Studies in which single- and paired-pulse TMS was applied during motor task performance have shed considerable light on the functional relevance of popular TMS-derived neurophysiological biomarkers such as short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI). While it has become well established that corticospinal excitability and intracortical inhibition are modulated during the enactment and cancellation of actions, it has remained unclear as to whether interindividual differences in these neurophysiological markers were associated with an individual's actual ability to restrain and cancel actions. In this study, we found that individual differences in both SICI and LICI were positively associated with relevant performance metrics on the go/no-go task and stop-signal task. Specifically, we found that individuals with greater resting SICI and LICI were faster to respond on go trials of the go/no-go task and were also more accurate at inhibiting their manual responses on both go/no-go and stop-signal tasks. These results are in support of findings from our earlier study and also provide new evidence for a general relationship between individual differences in resting-state GABAergic intracortical inhibitory functioning and motor inhibition.

Electrostatic rogue waves in double pair plasmas.

A nonlinear Schrödinger equation is derived to investigate the modulational instability of ion-acoustic (IA) waves (IAWs) in a double pair plasma system containing adiabatic positive and negative ion fluids along with super-thermal electrons and positrons. The analytical analysis predicts two types of modes, viz., fast ( ω f ) and slow ( ω s ) IA modes. The possible stable and unstable parametric regions for the IAWs in the presence of external perturbation can be observed for both ω f and ω s . The number density of the negative ions and positrons plays a vital role in generating the IA rogue waves in the modulationally unstable region. The applications of our present work in astrophysical environments [viz., D-region (H + , O 2 - ) and F-region (H + , H - ) of the Earth's ionosphere] and in laboratory plasmas [viz., pair-ion fullerene (C + , C - )] are pinpointed.

Heavy ion-acoustic rogue waves in electron-positron multi-ion plasmas.

The nonlinear propagation of heavy-ion-acoustic (HIA) waves (HIAWs) in a four-component multi-ion plasma (containing inertial heavy negative ions and light positive ions, as well as inertialess nonextensive electrons and positrons) has been theoretically investigated. The nonlinear Schrödinger (NLS) equation is derived by employing the reductive perturbation method. It is found that the NLS equation leads to the modulational instability (MI) of HIAWs, and to the formation of HIA rogue waves (HIARWs), which are due to the effects of nonlinearity and dispersion in the propagation of HIAWs. The conditions for the MI of HIAWs and the basic properties of the generated HIARWs are identified. It is observed that the striking features (viz., instability criteria, growth rate of MI, amplitude and width of HIARWs, etc.) of the HIAWs are significantly modified by the effects of nonextensivity of electrons and positrons, the ratio of light positive ion mass to heavy negative ion mass, the ratio of electron number density to light positive ion number density, the ratio of electron temperature to positron temperature, etc. The relevancy of our present investigation to the observations in space (viz., cometary comae and earth's ionosphere) and laboratory (viz., solid-high intense laser plasma interaction experiments) plasmas is pointed out.

Genome-wide association study on antipsychotic-induced weight gain in the CATIE sample.

Antipsychotic-induced weight gain (AIWG) is a common side effect with a high genetic contribution. We reanalyzed genome-wide association study (GWAS) data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) selecting a refined subset of patients most suitable for AIWG studies. The final GWAS was conducted in N=189 individuals. The top polymorphisms were analyzed in a second cohort of N=86 patients. None of the single-nucleotide polymorphisms was significant at the genome-wide threshold of 5x10(-8). We observed interesting trends for rs9346455 (P=6.49x10(-6)) upstream of OGFRL1, the intergenic variants rs7336345 (P=1.31 × 10(-5)) and rs1012650 (P=1.47 × 10(-5)), and rs1059778 (P=1.49x10(-5)) in IBA57. In the second cohort, rs9346455 showed significant association with AIWG (P=0.005). The combined meta-analysis P-value for rs9346455 was 1.09 × 10(-7). Our reanalysis of the CATIE GWAS data revealed interesting new variants associated with AIWG. As the functional relevance of these polymorphisms is yet to be determined, further studies are needed.The Pharmacogenomics Journal advance online publication, 1 September 2015; doi:10.1038/tpj.2015.59.

Identification of a novel class of covalent modifiers of hemoglobin as potential antisickling agents.

Aromatic aldehydes and ethacrynic acid (ECA) exhibit antipolymerization properties that are beneficial for sickle cell disease therapy. Based on the ECA pharmacophore and its atomic interaction with hemoglobin, we designed and synthesized several compounds - designated as KAUS (imidazolylacryloyl derivatives) - that we hypothesized would bind covalently to ßCys93 of hemoglobin and inhibit sickling. The compounds surprisingly showed weak allosteric and antisickling properties. X-ray studies of hemoglobin in complex with representative KAUS compounds revealed an unanticipated mode of Michael addition between the ß-unsaturated carbon and the N-terminal αVal1 nitrogen at the α-cleft of hemoglobin, with no observable interaction with ßCys93. Interestingly, the compounds exhibited almost no reactivity with the free amino acids, L-Val, L-His and L-Lys, but showed some reactivity with both glutathione and L-Cys. Our findings provide a molecular level explanation for the compounds biological activities and an important framework for targeted modifications that would yield novel potent antisickling agents.

Zoonotic bacterial pathogens and mixed crop-livestock farming.

Use of mixed crop-livestock farms (MCLFs) is one of the oldest and most traditional farming methods practiced all over the world, and MCLFs are still one of the major systems of food production, particularly for organic foods. On these typically small farms, livestock are reared primarily on grass and naturally grown crops, while composted animal wastes are used to fertilize the soil for growing crops. Specific to organic MCLFs, biosecurity challenges arise from the fact that animals are reared outdoors, which increases potential for contact with disease vectors including wild birds, rodents, and insects. Organic regulations do not allow the use of chemicals and antibiotics; therefore, alternative methods for control of disease and zoonotic pathogens must be used. Due to the biosecurity challenges and the complexity of the MCLF environment, methods for control of zoonotic pathogens need to be carefully considered in order to be effective and to abide by organic regulations if required. The objectives of this study are to define the complex routes of transmission, as well as the prevalence of potential zoonotic and possible interruption strategies of these pathogens among the food animals and crops produced on MCLFs.

Birth prevalence of congenital cytomegalovirus among infants of HIV-infected women on prenatal antiretroviral prophylaxis in South Africa.

BACKGROUND: A high rate of congenital cytomegalovirus (CMV) has been documented in human immunodeficiency virus (HIV)-exposed infants in industrialized settings, both in the pre- and post-highly active antiretroviral therapy (HAART) era. Only limited data on the birth prevalence of congenital CMV among infants of HIV-infected women on prenatal antiretroviral (ARV) prophylaxis are available from sub-Saharan Africa, despite a high prevalence of both infections. We evaluated the prevalence of congenital CMV in HIV-exposed infants in the Western Cape, South Africa. METHODS: HIV-infected mothers were recruited in the immediate postnatal period at a referral maternity hospital between April and October 2012. Maternal and infant clinical data and newborn saliva swabs were collected. Saliva swabs were assayed by real-time polymerase chain reaction for CMV. Data were analyzed using univariate and multivariate logistic regression analyses to determine specific demographic, maternal, and newborn characteristics associated with congenital CMV. RESULTS: CMV was detected in 22 of 748 newborn saliva swabs (2.9%; 95% confidence interval [CI], 1.9%-4.4%). Overall, 96% of mothers used prenatal ARV prophylaxis (prenatal zidovudine, 43.9%; HAART, 52.1%). Maternal age, gestational age, prematurity (<37 weeks' gestation), type of ARV prophylaxis, length of ARV prophylaxis, birth weight, small for gestational age, and infant feeding choice were not significantly different between CMV-infected and -uninfected infants. Maternal CD4 count <200 cells/µL during pregnancy was independently associated with congenital CMV (adjusted odds ratio, 2.9; 95% CI, 1.2-7.3). A negative correlation between CMV load in saliva and maternal CD4 count was observed (r = -0.495, n = 22, P = .019). CONCLUSIONS: The birth prevalence of congenital CMV was high despite prenatal ARV prophylaxis, and was associated with advanced maternal immunosuppression.

Induced neurocysticercosis in rhesus monkeys (Macaca mulatta) produces clinical signs and lesions similar to natural disease in man.

Neurocysticercosis is a serious endemic zoonosis resulting in increased cases of seizure and epilepsy in humans. The genesis of clinical manifestations of the disease through experimental animal models is poorly exploited. The monkeys may prove useful for the purpose due to their behavior and cognitive responses mimicking man. In this study, neurocysticercosis was induced in two rhesus monkeys each with 12,000 and 6,000 eggs, whereas three monkeys were given placebo. The monkeys given higher dose developed hyperexcitability, epileptic seizures, muscular tremors, digital cramps at 10 DPI, and finally paralysis of limbs, followed by death on 67 DPI, whereas the monkeys given lower dose showed delayed and milder clinical signs. On necropsy, all the infected monkeys showed numerous cysticerci in the brain. Histopathologically, heavily infected monkeys revealed liquefactive necrosis and formation of irregular cystic cavities lined by atrophied parenchymal septa with remnants of neuropil of the cerebrum. In contrast, the monkeys infected with lower dose showed formation of typical foreign body granulomas characterized by central liquefaction surrounded by chronic inflammatory response. It was concluded that the inflammatory and immune response exerted by the host against cysticerci, in turn, led to histopathological lesions and the resultant clinical signs thereof.

Radiologic evaluation of hyperacute brain infarction: a review.

Imaging cerebral infarction in first few hours after the onset of clinical symptoms is a challenge. The role of stroke imaging underwent a paradigm shift from confirmation of infarction from and exclusion of hemorrhage to the detection of the tissue at risk that may be rescued with restoration of circulation. Computed tomography (CT) is generally performed before starting the therapy in order to exclude the presence of bleeding and tumors. Although CT may show findings of infarction as early as 3-6 hours after ictus 30% of CT scans are normal in the first few hours after ischemic insult. Conventional spin-echo MR imaging is more sensitive and specific than CT in the detection of cerebral ischemia during the 1st few hours symptom onset. Lesion conspicuity can be further optimized by using an FLAIR sequence. Diffusion-weighted MR imaging is a technique that is more sensitive than conventional MR imaging for detection of hyperacute cerebral ischemia, within minutes after the onset of ischemia, a profound restriction in water diffusion occurs in affected brain tissue and DWI is sensitive to diffusion restriction. But DWI only shows areas that are already irreversibly damaged. Around this core, there is believed to be a region of ischemic penumbra where reversible cell death occurred. An imaging technique that accurately identifies this tissue at risk could have a tremendous impact on patient management by thrombolysis. Perfusion imaging allows depiction of both areas of irreversible ischemia and areas of reversible ischemia. Both MR and CT Perfusion imaging help define the tissue at risk. The introduction of intravenous thrombolysis with tPA has radically changed the role of neuroimaging for stroke evaluation. The ECASS trial prescribed for treatment with intravenous tPA with stroke symptoms of less than 6 hours in duration and who did not have identifiable infarction of greater than one- third of the middle cerebral artery (MCA) territory on CT images. The NINDS trial established that intravenous tPA treatment is efficacious if administered less than 3 hours after symptom onset. The experience of interventional cardiologists in treating acute myocardial infarction may predict the future of intervention neuro in treating ischemic stroke.

Relationship between estimated foetal weight and renal volume in intra uterine growth retarded foetus in Bangladeshi women.

Low birth weight (LBW) baby predisposes to long term renal disease, adult hypertension and related cardiovascular disease. This could be due to reduced nephron number in early life. From different studies, it is becoming increasingly clear that nephron number, indirectly reflected in renal volume may be related with normal or retarded foetal growth. This prospective study was undertaken in the department of Obstetric and Gynae in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. One hundred pregnant women were included in this study and divided into two groups (IUGR and normally growing foetuses). Forty one foetuses weighted less than 2.5kg and fifty nine foetuses weighed 2.5kg or more. Kidney dimensions and estimated feotal weight were measured by USG by the same ultrasonologist. There were no significant difference between two groups regarding age, height, weight, and parity. The subjects with intrauterine growth retardation had smaller head circumference, abdominal circumferences, biparietal diameters, femur length, estimated foetal weight and lower amniotic fluid indices than did the subjects with non-intrauterine growth retardation (IUGR). All biometric data shows significant deference except head circumference (HC). Intrauterine growth retardation (IUGR) foetus had significantly lower kidney volume than normally growing foetuses.

In vitro and In vivo evidence demonstrating chronic absence of Ref-1 Cysteine 65 impacts Ref-1 folding configuration, redox signaling, proliferation and metastasis in pancreatic cancer.

Ref-1/APE1 (Redox Effector/Apurinic Endonuclease 1) is a multifunctional enzyme that serves as a redox factor for several transcription factors (TFs), e.g., NF-kB, HIF-1α, which in an oxidized state fail to bind DNA. Conversion of these TFs to a reduced state serves to regulate various biological responses such as cell growth, inflammation, and cellular metabolism. The redox activity involves a thiol exchange reaction for which Cys65 (C65) serves as the nucleophile. Using CRISPR editing in human pancreatic ductal adenocarcinoma (PDAC) cells, we changed C65 to Ala (C65A) in Ref-1 to evaluate alteration of Ref-1 redox dynamics as well as chronic loss of Ref-1 redox activity on cell signaling pathways, specifically those regulated by NF-kB and HIF-1α. The redox activity of Ref-1 requires partial unfolding to expose C65, which is buried in the folded structure. Labeling of Ref-1 with polyethylene glycol-maleimide (PEGm) provides a readout of reduced Cys residues in Ref-1 and thereby an assessment of partial unfolding in Ref-1. In comparing Ref-1WT vs Ref-1C65A cell lines, we found an altered distribution of oxidized versus reduced states of Ref-1. Accordingly, activation of NF-kB and HIF-1α in Ref-1C65A lines was significantly lower compared to Ref-1WT lines. The bioinformatic data revealed significant downregulation of metabolic pathways including OXPHOS in Ref-1C65A expressing clones compared to Ref-1WT line. Ref-1C65A also demonstrated reduced cell proliferation and use of tricarboxylic acid (TCA) substrates compared to Ref-1WT lines. A subcutaneous as well as PDAC orthotopic in vivo model demonstrated a significant reduction in tumor size, weight, and growth in the Ref-1C65A lines compared to the Ref-1WT lines. Moreover, mice implanted with Ref-1C65A redox deficient cells demonstrate significantly reduced metastatic burden to liver and lung compared to mice implanted with Ref-1 redox proficient cells. These results from the current study provide direct evidence that the chronic absence of Cys65 in Ref-1 results in redox inactivity of the protein in human PDAC cells, and subsequent biological results confirm a critical involvement of Ref-1 redox signaling and tumorigenic phenotype.

Unique territorial and compartmental organization of chromosomes in the holocentric silkmoth.

The hallmarks of chromosome organization in multicellular eukaryotes are chromosome territories (CT), chromatin compartments, and insulated domains, including topologically associated domains (TADs). Yet, most of these elements of chromosome organization are derived from analyses of a limited set of model organisms, while large eukaryotic groups, including insects, remain mostly unexplored. Here we combine Hi-C, biophysical modeling, and microscopy to characterize the 3D genome architecture of the silkmoth, Bombyx mori. In contrast to other eukaryotes, B. mori chromosomes form highly separated territories. Similar to other eukaryotes, B. mori chromosomes segregate into active A and inactive B compartments, yet unlike in vertebrate systems, contacts between euchromatic A regions appear to be a strong driver of compartmentalization. Remarkably, we also identify a third compartment, called secluded "S," with a unique contact pattern. Each S region shows prominent short-range self-contacts and is remarkably devoid of contacts with the rest of the chromosome, including other S regions. Compartment S hosts a unique combination of genetic and epigenetic features, localizes towards the periphery of CTs, and shows developmental plasticity. Biophysical modeling reveals that the formation of such secluded domains requires highly localized loop extrusion within them, along with a low level of extrusion in A and B. Our Hi-C data supports predicted genome-wide and localized extrusion. Such a broad, non-uniform distribution of extruders has not been seen in other organisms. Overall, our analyses support loop extrusion in insects and highlight the evolutionary plasticity of 3D genome organization, driven by a new combination of known processes.

Genetic association study between antipsychotic-induced weight gain and the melanocortin-4 receptor gene.

Antipsychotic-induced weight gain (AIWG) may result in the metabolic syndrome in schizophrenia (SCZ) patients. Downstream variants of the melanocortin-4 receptor (MC4R) gene have been associated with obesity in various populations. Thus, we examined single-nucleotide polymorphisms (SNPs) in the MC4R region for association with AIWG in SCZ patients. Four SNPs (rs2229616, rs17782313, rs11872992 and rs8087522) were genotyped in 224 patients who underwent treatment for SCZ and were evaluated for AIWG for up to 14 weeks. We compared weight change (%) across genotypic groups using analysis of covariance for three SNPs (r²≤0.8). European-ancestry patients who were rs8087522 A-allele carriers (AG+AA) on clozapine gained significantly more weight than non-carriers (P=0.027, n=69). These observations were marginal after correction for multiple testing. We performed in vitro electrophoretic mobility-shift assay that suggested that the presence of the A-allele may create a transcription factor-binding site. Further investigation is warranted for both these exploratory findings.

Pharmacogenetics of antipsychotic-induced weight gain: review and clinical implications.

Second-generation antipsychotics (SGAs), such as risperidone, clozapine and olanzapine, are the most common drug treatments for schizophrenia. SGAs presented an advantage over first-generation antipsychotics (FGAs), particularly regarding avoidance of extrapyramidal symptoms. However, most SGAs, and to a lesser degree FGAs, are linked to substantial weight gain. This substantial weight gain is a leading factor in patient non-compliance and poses significant risk of diabetes, lipid abnormalities (that is, metabolic syndrome) and cardiovascular events including sudden death. The purpose of this article is to review the advances made in the field of pharmacogenetics of antipsychotic-induced weight gain (AIWG). We included all published association studies in AIWG from December 2006 to date using the Medline and ISI web of knowledge databases. There has been considerable progress reaffirming previous findings and discovery of novel genetic factors. The HTR2C and leptin genes are among the most promising, and new evidence suggests that the DRD2, TNF, SNAP-25 and MC4R genes are also prominent risk factors. Further promising findings have been reported in novel susceptibility genes, such as CNR1, MDR1, ADRA1A and INSIG2. More research is required before genetically informed, personalized medicine can be applied to antipsychotic treatment; nevertheless, inroads have been made towards assessing genetic liability and plausible clinical application.

Development of some larval nematodes in experimental and natural animal hosts: an insight into development of pathological lesions vis-a-vis host-parasite interactions.

Infective third-stage larvae of three spiruroid nematodes, Ascarops strongylina and Physocephalus sexalatus of pigs and Spirocerca lupi of dogs, were recovered from 14 species of coprophagous beetles belonging to 4 different genera. These larvae were fed to rabbits and/or guinea pigs to study their development in these experimental hosts. Larvae of A. strongylina reached the adult stage in all rabbits and one guinea pig. The adult worms recovered in these hosts were 40% and 4%, respectively, and became diminutive in comparison to their natural hosts. The larvae of P. sexalatus became reencysted in the gastric wall of rabbits inducing marked pathological changes. The infective larvae of S. lupi became reencapsulated in the stomach wall of the rabbit and also showed development in the aortic wall. Adults of Toxocara canis of dog, collected from 5 different regions of the Indian subcontinent, varied significantly in size. The mouse passage of infective larvae of one of these types led to the recovery of the adults from the experimental dogs that were smaller in size and caused severe pathology in natural experimental hosts. Developmental effects shown in experimental hosts and host specificity are of value in understanding the evolution of nematode parasitism.

Comparison of modified Friedewald's formula with direct measurement of low-density lipoprotein cholesterol in Bangladeshi population.

A modification of Friedewald's formula to estimate serum low-density lipoprotein cholesterol (LDLC) up to serum triglyceride (TG) level of 11.3 mmol/L in Bangladeshi population has recently been published. The aim of this study was to compare the modified formula with direct measurement of LDLC in Bangladeshi population in a different setting. One thousand and fifty two specimens from adult subjects were analyzed. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), LDLC and TG were measured by standard methods. The modified Friedewald's formula was applied to estimate LDL cholesterol concentration. Results were expressed as mean ± SD and calculated LDLC was compared with measured LDLC by two-tailed paired t test, Bland-Altman plot for absolute bias, Pearson's correlation coefficients of calculated LDLC with measured LDLC and Passing & Bablok regression equation of calculated LDLC against measured LDLC. The mean ± SD of measured LDLC was 2.98 ± 0.82 mmol/L. LDLC calculated by modified Friedewald's formula was 2.77 ± 0.86 mmol/L. The mean absolute bias was -0.20 ± 0.32 mmol/L, Pearson's correlation coefficient (r) was 0.9293 (P < 0.0001) and Passing & Bablok regression equation was y = - 0.3856+1.0597x for modified formula up to serum TG ≤ 11.3 mmol/L. Compared to original Friedewald's formula, performance of the modified Friedewald's formula was better up to serum TG ≤ 4.52 mmol/L. The study reveals that the modified Friedewald's formula may be used to calculate LDLC approximately in Bangladeshi population.

Heart in Heart: A Case Report of Giant Left Atrial Appendage Aneurysm.

Left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly. The cause mostly due to congenital, but can be acquired also. Patient may remain asymptomatic or may present with variable symptom. It can predispose to hazardous adverse events, including atrial fibrillation, myocardial infarction, cardiac dysfunction and life-threatening systemic thromboembolism. Simple imaging, electrocardiography and echocardiography can diagnose this rare cardiac anomaly. We are reporting a case who presented to us at 5 years of age with palpitation, chest pain and dizziness with arrythmia that developed one month back; he visited our outpatient department of the National Heart Foundation Hospital & Research Institute Hospital, Dhaka, Bangladesh on 13th February 2020. We diagnosed left atrial appendage aneurysm with mitral valve prolapse with atrial arrhythmia thereafter surgical resection of aneurysmal part along with mitral valve annuloplasty done by mid sternotomy and maze therapy. Postoperative period was uneventful and discharged after 6th post operative day.

Intramuscular injection of nerve growth factor as a model of temporomandibular disorder: nature, time-course, and sex differences characterising the pain experience.

Background: Temporomandibular disorder (TMD) is a common condition that frequently transitions to chronic symptoms. Experimental pain models that mimic the symptoms of clinical TMD may be useful in understanding the mechanisms, and sex differences, present in this disorder. Here we aimed to comprehensively characterise the nature and time-course of pain, functional impairment and hyperalgesia induced by repeated intramuscular injection of nerve growth factor (NGF) into the masseter muscle, and to investigate sex differences in the NGF-induced pain experience. Methods: 94 healthy individuals participated in a longitudinal study with 30-day follow-up. NGF was injected into the right masseter muscle on Day 0 and Day 2. Participants attended laboratory sessions to assess pain (Numerical Rating Scale; NRS), functional limitation (mouth opening distance, Jaw Functional Limitation Scale; JFLS) and mechanical sensitization (pressure pain thresholds; PPTs) on Days 0, 2 and 5 and completed twice daily electronic pain dairies from Day 0 to day 30. Results: Peak pain averaged 2.0/10 (95 % CI: 1.6-2.4) at rest and 4.3/10 (95 % CI: 3.9-4.8) on chewing. Pain-free mouth opening distance reduced from 5.0 cm (95 % CI: 4.8-5.1 cm) on Day 0 to 3.7 cm (95 % CI: 3.5-3.9 cm) on Day 5. The greatest reduction in PPTs was observed over the masseter muscle. Females experienced higher pain, greater functional impairment, and greater sensitivity to mechanical stimuli than males. Conclusion: Intramuscular injection of NGF is a useful model with which to explore the mechanisms, and sex differences, present in clinical TMD.

Functional and Speech Outcome of Unilaterally Cochlear Implanted Children after 1 year of Implantation in NIENT: A Retrospective Study.

Hearing loss can be congenital or acquired. Most of the time congenital hearing loss means profound sensorineural hearing loss. The invention of cochlear implantation has already an established role in improving the hearing capability in congenital sensorineural hearing loss. To speak properly after cochlear implant, one needs to go for speech therapy or audio-verbal therapy. Speech therapy has become an integral part of the cochlear implantation program. In Bangladesh cochlear implantation (CI) programs started around 15 years ago, which was limited to Bangabandhu Sheikh Mujib Medical University (BSMMU) and Combined Military Hospital (CMH). Our government takes initiative to provide this service to poor and lower income people. National Institute of ENT (NIENT) was the first government hospital where CI started in 2018 and the project is now ongoing. After CI auditory, verbal therapy (AVT) was given at the same institute. No study has not been done to find out the outcome of AVT. NIENT has taken steps to find out the functional and speech outcome of cochlear implanted children considering the two standard criteria: CAP and SIR score. This retrospective study was done to find out the auditory verbal outcome of unilaterally CI children in different ages and conducted at department of Audiology, National Institute of ENT, Tejgaon, Dhaka, Bangladesh from January 2021 to June 2021. The children who underwent cochlear implants and took the auditory verbal therapy were included in this study. Though it is a retrospective study, a written informed consent has been taken from the patient's parents as the cases are minor in age. From the record review, CAP and SIR scores were recorded four times: before implantation 1 time, after cochlear implantation 3 times (At the end of 3, 6 and 12 months after starting of AVT of Cochlear implantees). From the study it has been observed that out of 50 implantees, 48.0% of children's age range was in between >3 to ≤5 years. Most of the implantees were from rural areas and also from lower income group. The study showed significant association with CAP and SIR score at the end of one year of AVT. No significant association was found in different age groups with scores of CAP and SIR. But the parent's education showed significant association with CAP score at the end one year of AVT. Though the age of the recipient is not significantly associated with the AVT outcome but maternal education plays an important role in improving CAP and SIR score. So, maternal education or understanding along with professional speech therapy is vital for better AVT outcome.