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Sepsis-related mortality continues to be a major concern while treating pediatric cancer patients, more so with the rise in the incidence of multidrug-resistant organisms (MDRO). In this retrospective study conducted between January 2021 and December 2022 at a tertiary cancer center in India, granulocyte transfusion was offered in addition to standard antimicrobial therapy to 64 children with hematolymphoid malignancy who developed 75 episodes of severe sepsis following intensive chemotherapy. Forty-four (83%) of 53 blood culture proven sepsis was caused by MDROs. Thirty-seven (70%) patients with blood culture proven sepsis cleared the organism after granulocyte transfusion. Thirty-day mortality was 25% for the entire study cohort and 32% for patients with MDRO sepsis.
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BACKGROUND: Hemato-oncologic patients receiving intensive chemotherapy may develop severe neutropenia and serious bacterial and/or fungal infections. Granulocyte transfusions (GTs) may be beneficial as a bridging therapy in hemato-oncologic patients with febrile neutropenia. AIM: To evaluate the clinical effectiveness of GTs in hemato-oncologic patients with febrile neutropenia. MATERIALS AND METHODS: This retrospective study evaluated the effectiveness of 150 GTs in 88 hemato-oncologic patients. Donors were mobilized with granulocyte colony-stimulating factors and dexamethasone. Patients' hematological parameters (pre- and post-GT) and safety and effectiveness of GTs were analyzed. RESULTS: The safety and effectiveness of GTs were assessed in the patients with various underlying conditions, including 78% with acute myeloid leukemia. In total, 150 GTs were administered, mostly during the chemotherapy induction phase. The GTs were well-tolerated by the patients, and a significant increment in white blood cell count and absolute neutrophil count (ANC) was noticed in 95% of patients after the transfusion. The granulocyte dose was positively correlated with ANC after the transfusion. The average time to neutrophil recovery from the last day of GT was 6.7 days, and the 30-day survival rate was 77%. The donors were all men, and a significant increase in WBC count was observed post-mobilization. The median granulocyte yield was 2.28 × 1010 /unit. All granulocyte products were crossmatched and irradiated before the transfusion. CONCLUSION: GTs can be a useful adjunctive treatment for febrile neutropenia in hemato-oncologic patients with multidrug-resistant sepsis. However, additional studies are required for confirming their effectiveness and establishing guidelines for their use.
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Neutropenia Febril , Granulócitos , Masculino , Humanos , Estudos Retrospectivos , Neutrófilos , Transfusão de Leucócitos , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Índia , Neutropenia Febril/terapiaRESUMO
BACKGROUND: Plateletpheresis is a safe procedure, and the most common reaction is hypocalcemia which is transient and self-limiting, but it can have an impact on donor experience and donor return rate. AIM: To serially monitor the ionized calcium levels of the plateletpheresis donors and to correlate with symptoms of hypocalcemia if any. METHODS: It was a prospective observational study in 126 healthy voluntary donors eligible for plateletpheresis as per the Departmental SOP and after taking written informed consent. Procedures were conducted on continuous flow centrifugation (CFC) and intermittent flow centrifugation (IFC) cell separators. Donor blood samples were collected in pre-heparinized syringes at different intervals to measure ionized calcium levels (iCa++) by venous blood gas analysis (Cobas 221). RESULTS: There was a continuous and gradual decrease in iCa++ from start to 30-45 minutes during the procedure; while the levels showed a gradual increase at end of the procedure and reached near the baseline values after 15-30 min of completion of the procedure. The change in iCa++ was statistically significant at 30 min and 45 min (p < 0.05), which was correlated with symptoms of hypocalcemia observed in 32.5 % (41/126) of the donors. Females experienced more symptoms of hypocalcemia as compared to males (p < 0.01). Donors who underwent plateletpheresis on the IFC machine experienced more symptoms of hypocalcemia as compared to the CFC machine (p < 0.05). CONCLUSION: For donors with persistent symptoms of hypocalcemia which are unrelieved by procedural modifications (reducing blood return rate, citrate infusion rate, etc.) measurement of iCa++ and administration of oral calcium tablets may be considered.
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Hipocalcemia , Plaquetoferese , Doadores de Sangue , Cálcio , Feminino , Humanos , Masculino , Atenção Terciária à SaúdeRESUMO
BACKGROUND: Teaching and learning Community-Based Medical Education (CBME) requires the active engagement of students in various activities to cover planned curricular content. CBME being multifaceted involves careful application and formation of links when attending to community health problems and public health issues. Students often depend on factual recall rather than 'engaging in', to counteract the broad and comprehensive nature of CBME. This study was conducted to assess the effectiveness of Visual mapping techniques as a learning tool in a CBME program for the subject Community Medicine and thereby assist medical undergraduate students in overcoming identified learning challenges. METHODOLOGY: An interventional study was conducted where medical undergraduates were randomly assigned to two different groups (each group = 30). After sensitization, a broad theme was taught to both the groups as a part of community-based teaching (CBT), each week for a month. The students in the intervention group were given the assignment to draw visual maps using the mind mapping & concept mapping techniques, after each CBT session, while the control group had Question-Answer session with built-in discussion (Conventional method) by an equally qualified, experienced faculty with no mapping assignments. A surprise written examination was conducted on the topics taught, and scores of both the groups were compared. Feedback was obtained from the intervention group. RESULTS: Mean score of the examination by the intervention group (29.85 ± 3.22) was significantly higher than and that of the control group (23.06 ± 4.09) (t = 7.14 and p < 0.05). The students shared that the assignment of drawing mind and concept maps for topics taught helped in attempting questions of the written examination by facilitating easy recall of the information learned. It aided to frame the answers to descriptive questions in a structured way with the use of keywords. However, identifying the concepts and establishing relationship between them was slightly challenging. CONCLUSION: 'Visual mapping' in the form of Mind and Concept mapping was found to be an effective learning tool for multifaceted CBME especially in promoting meaningful learning and facilitating rational thinking by the medical undergraduates.
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Educação de Graduação em Medicina , Educação Médica , Estudantes de Medicina , Avaliação Educacional , Humanos , Aprendizagem , EnsinoRESUMO
The non-invasive food grade Lactococcus lactis (L. lactis) represents a safe and attractive alternative to invasive pathogens for the delivery of plasmid DNA at mucosal sites. We have earlier shown the DNA delivery potential of r-L. lactis harboring DNA vaccine reporter plasmid; pPERDBY in vitro. In the present work, we examined in vivo delivery potential of food grade non-invasive r-L. lactis::pPERDBY (LacVax® DNA-I) in BALB/c mice. Moreover, using EGFP as a model antigen, we also characterized and compared the immune response elicited by LacVax® DNA-I with other conventional vaccination approaches using protein and naked DNA immunization. The presence of antigen-specific serum IgG and fecal secretory IgA (sIgA) antibodies demonstrated in vivo DNA delivery and immune elicitation potential of the developed LacVax® DNA-I. As compared with intramuscular injection, oral delivery of pPERDBY via L. lactis resulted in a significantly rapid increase in IgG and higher sIgA titers, indicating the immunogenic and immunostimulatory properties of the LacVax® DNA-I. The needle-free immunization with LacVax® DNA-I led to increased production of IL-4, an indicator of Th2 screwed response. To the best of our knowledge, this report for the first time outlines comparison of orally administered LacVax® DNA-I with other conventional vaccination approaches.
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Técnicas de Transferência de Genes , Imunoglobulina G/genética , Interleucina-4/imunologia , Lactococcus lactis/genética , Administração Oral , Animais , Imunização/métodos , Imunoglobulina G/imunologia , Injeções Intramusculares , Interleucina-4/genética , Lactococcus lactis/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Plasmídeos/administração & dosagem , Plasmídeos/genética , Células Th2/imunologiaRESUMO
Food grade Lactococcus lactis has been widely used as an antigen and DNA delivery vehicle. We have previously reported the use of non-invasive L. lactis to deliver the newly constructed immunostimulatory DNA vaccine reporter plasmid, pPERDBY. In the present report, construction of dual recombinant L. lactis expressing internalin A of Listeria monocytogenes and harboring pPERDBY (LL InlA + pPERDBY) to enhance the efficiency of delivery of DNA by L. lactis is outlined. After confirmation and validation of LL InlA + pPERDBY, its DNA delivery potential was compared with previously developed non-invasive r- L. lactis::pPERDBY. The use of invasive L. lactis resulted in around threefold increases in the number of enhanced green fluorescent protein-expressing Caco-2 cells. These findings reinforce the prospective application of invasive strain of L. lactis for delivery of DNA/RNA and antigens.
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Portadores de Fármacos , Lactococcus lactis/genética , Vacinas de DNA/administração & dosagem , Proteínas de Bactérias/genética , Células CACO-2 , Genes Reporter , Proteínas de Fluorescência Verde/análise , Proteínas de Fluorescência Verde/genética , Humanos , Plasmídeos , Vacinas de DNA/genéticaRESUMO
Potential use of Lactococcus lactis (L. lactis) as a heterologous protein expression host as well as for delivery of multiple therapeutic proteins has been investigated extensively using Nisin Inducible Controlled Expression (NICE) system. Optimum inducible expression of heterologous protein by NICE system in L. lactis depends on multiple factors. To study the unexplored role of factors affecting heterologous protein expression in L. lactis using NICE, the present study outlines the optimization of various key parameters such as inducer concentration, host's proteases and precipitating agent using Outer membrane protein A (OmpA). For efficient expression and secretion of OmpA, pSEC:OmpA vector was successfully constructed. To circumvent the troubles encountered during detection of expressed OmpA, the precipitating agent was switched from TCA to methanol. Nevertheless, detection was achieved accompanied by degraded protein products. Speculating the accountability of observed degradation at higher inducer concentration, different nisin concentrations were evaluated. Lower nisin concentrations were found desirable for optimum expression of OmpA. Consistently observed degradation was eliminated by incorporation of protease inhibitor cocktail which inhibits intracellular proteases and expression in VEL1153 (NZ9000 ΔhtrA) strain which inhibits extracellular protease leading to optimum expression of OmpA. Versatility and complexity of NICE system in L. lactis requires fine-tuning of target protein specific parameters for optimum expression.
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OBJECTIVE: Due to multiple issues, integrated interdisciplinary palliative care teams in a neonatal intensive care unit (NICU) may be difficult to access, sometimes fail to be implemented, or provide inconsistent or poorly coordinated care. When implementing an effective institution-specific neonatal palliative care program, it is critical to include stakeholders from the clinical, operational, and financial worlds of healthcare. In this study, researchers sought to gain a multidisciplinary perspective into issues that may impact the implementation of a formal neonatal palliative care program at a tertiary regional academic medical center. METHOD: In this focused ethnography, the primary researcher conducted semistructured interviews that explored the perspectives of healthcare administrators, finance officers, and clinicians about neonatal palliative care. The perspectives of 39 study participants informed the identification of institutional, financial, and clinical issues that impact the implementation of neonatal palliative care services at the medical center and the planning process for a formal palliative care program on behalf of neonates and their families. RESULTS: Healthcare professionals described experiences that influenced their views on neonatal palliative care. Key themes included: (a) uniqueness of neonatal palliative care, (b) communication and conflict among providers, (c) policy and protocol discrepancies, and (d) lack of administrative support. SIGNIFICANCE OF RESULTS: The present study highlighted several areas that are challenging in the provision of neonatal palliative care. Our findings underscored the importance of recognizing and procuring resources needed simultaneously from the clinical, operational, and financial worlds in order to implement and sustain a successful neonatal palliative care program.
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Atitude do Pessoal de Saúde , Unidades de Terapia Intensiva Neonatal , Neonatologia/métodos , Cuidados Paliativos/métodos , Adulto , Antropologia Cultural , Feminino , Humanos , Recém-Nascido , Comunicação Interdisciplinar , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Política Organizacional , Técnicas de PlanejamentoRESUMO
AIM: This literature review offers a response to the current paediatric palliative care literature that will punctuate the need for a framework (i.e. the three world view) that can serve as an evaluative lens for nurse managers who are in the planning or evaluative stages of paediatric palliative care programmes. BACKGROUND: The complexities in providing paediatric palliative care extend beyond clinical practices to operational policies and financial barriers that exist in the continuum of services for patients. EVALUATION: This article offers a review of the literature and a framework in order to view best clinical practices, operational/policy standards and financial feasibility when considering the development and sustainability of paediatric palliative care programmes. KEY ASPECTS: Fifty-four articles were selected as representative of the current state of the literature as it pertains to the three world view (i.e. clinical, operational and financial factors) involved in providing paediatric palliative care. CONCLUSION: In developing efficient paediatric palliative care services, clinical, operational and financial resources and barriers need to be identified and addressed. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing management plays a crucial role in addressing the clinical, operational and financial needs and concerns that are grounded in paediatric palliative care literature.
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Cuidados Paliativos/métodos , Enfermagem Pediátrica/métodos , Criança , Implementação de Plano de Saúde/economia , Implementação de Plano de Saúde/métodos , Humanos , Enfermeiros Administradores , Cuidados Paliativos/economia , Enfermagem Pediátrica/economiaRESUMO
Saudi Arabia has made substantial advancements in its pediatric healthcare infrastructure. However, substantial gaps persist in addressing hospitalized children's emotional safety, and psychosocial and developmental needs. Internationally, the child life profession has evolved over decades to specifically address these needs, through interventions such as therapeutic play, age-appropriate patient education, and family support. This article evaluates the imperative for integrating the child life profession into healthcare services in Saudi Arabia to transform the quality of pediatric healthcare. An analysis of the current landscape revealed gaps in pediatric psychosocial care. These gaps are listed as national priorities in the health transformation program aimed at improving healthcare quality and enhancing well-being. Integrating the child life profession can help achieve these objectives for children and families in Saudi Arabia. This article highlights the multifaceted benefits of the child life profession in improving patient experiences, healthcare delivery efficiency, pediatric healthcare quality, and the overall well-being of children and families. Strategies for phased implementation, involving healthcare institutions, academic partners, relevant non-profit partners, and policymakers, are proposed.
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AIM: The aim is to radiographically quantify the bone density and relate the same with observer strategy in the bone healing. OBJECTIVES: To assess pattern of bone regeneration following grafting of defects with hydroxyapatite after apicoectomy/cystic enucleation. MATERIALS AND METHODS: An observer strategy involving trained and experienced examiners used in large series of cases, evaluated radiographically over a period of 1 year with intervals. The cases were grouped into different categories depending on (1) surgical site outline merging with material margin, (2) internal portion of surgical site (i.e. bone formation characteristics) and (3) density of surgical site. The radiographs examined by blind process and the findings were tabulated. Operating surgeon (oral surgeon) has done the interpretation of data to create observer strategy of grafting cases. OBSERVATIONS AND RESULTS: The outline of the defect was changed, partly reduced and completely absent along with remodeling, which showed ground glass, specular or trabecular pattern of bone over a time with increasing density correlating bone regeneration within a short duration. The applied strategy and classification are recommended for follow-up studies. In this study the characteristics of the new bone formation were also delineated. This strategy is helpful for follow-up studies; implant procedures and so; to know quality and condition of bone after treatment.
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Substitutos Ósseos/uso terapêutico , Durapatita/uso terapêutico , Cistos Maxilomandibulares/cirurgia , Maxila/diagnóstico por imagem , Doenças Maxilares/cirurgia , Adulto , Apicectomia/métodos , Densidade Óssea/fisiologia , Regeneração Óssea/fisiologia , Remodelação Óssea/fisiologia , Seguimentos , Humanos , Cistos Maxilomandibulares/diagnóstico por imagem , Doenças Maxilares/diagnóstico por imagem , Variações Dependentes do Observador , Osteogênese/fisiologia , Doenças Periapicais/diagnóstico por imagem , Doenças Periapicais/cirurgia , Cisto Periodontal/diagnóstico por imagem , Cisto Periodontal/cirurgia , Cisto Radicular/diagnóstico por imagem , Cisto Radicular/cirurgia , Radiografia Dentária Digital/estatística & dados numéricosRESUMO
INTRODUCTION: In serological testing, determination of ABO grouping requires both antigen typing for A and B antigens and screening of serum or plasma for A and B antibodies. Lack of corroboration between the results of the cell and serum groupings identifies a discrepancy. Analysis of ABO blood group discrepancies was performed to determine the incidence of these discrepancies among healthy blood donors and oncology patients. MATERIALS AND METHODS: ABO discrepancies found during testing of blood samples from blood donors and patients in an oncology centre in the period from January 2015 to December 2018 were analysed. ABO blood grouping was performed using the column agglutination test. Detailed serological workups were carried out to resolve discrepancies. RESULTS: During the study period, a comprehensive analysis was conducted on a large dataset comprising 76,604 blood donor samples and 134,964 patient samples. Of these samples, 117 ABO discrepancies were identified with 13 occurring in blood donor samples and 104 in patient samples. The results demonstrated discrepancies caused by weakened/missing antibodies, weakened/missing antigens, panagglutination and miscellaneous factors in the blood donor samples, with percentages of 0%, 38%, 8%, and 31%, respectively. In patient samples, the percentages were 24%, 27%, 26%, and 15%, respectively. CONCLUSION: Weakened/missing antigen discrepancies were the prevalent type in both blood donor and patient samples. For accurate blood group reporting and management of transfusion needs of patients, a complete serological workup is vital to resolve any blood group discrepancies.
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This narrative review paper aims to build a common understanding of the vulnerabilities of children with chronic medical conditions who face exceptional challenges due to nature of the illness, deformity, injury, and traumatic healthcare encounters which could potentially lead to long-term psychological effects. The presence of chronic medical diagnoses in children and the subsequent impacts including social stigma, as well as their age and developmental level, may amplify adjustment challenges in parenting considerations, school, peer relations, career, and future relationships. Children may be traumatized by unfamiliar and painful healthcare experiences. Hospitalization can lead to increased feelings of isolation, fear, and self-doubt when children do not receive emotionally safe psychological support necessary to minimize the accompanying stress and anxiety. School experiences and parenting children with chronic illnesses have additional intersecting socialization characteristics. This paper highlights a vision for furthering the groundwork within Indian pediatric settings to promote emotional safety and psychosocial care. Principles from the United Nations Convention on the Rights of the Child and the World Health Organization's definition of health create an impetus for giving a voice to children with chronic medical conditions. While there are sporadic psychosocial services for children with chronic needs, they lack consistency, and this indicates a need and an opportunity for developing a unique career for human development and psychology professionals to address these concerns. As exemplars, two psychosocial care programs in India that help foster resilience in these children are highlighted. Although limited, extant research regarding the experiences of children with chronic medical conditions in India is discussed, and implications for future research and academic initiatives are interwoven within this paper.
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Objective: The purpose of the study is the evaluation and comparison of surface roughness and bond strength of glass fiber post (GFP) after different types of surface treatment and the application of a universal bonding agent. Materials and Methods: Forty GFPs were divided into four groups based on surface treatment: Group I, silane coupling agent application for 60 s; Group II, air abrasion with 30 µm silicon dioxide powder particles in 2.5 bar pressure from 2 cm distance for 10 s, followed by silane coupling agent application; Group III, 9% hydrofluoric acid application for 10 s, rinsed and air-dried, followed by silane coupling agent application; and Group IV, silane coupling agent application, followed by universal bonding agent application. Surface roughness evaluation is done by a profilometer. All posts were cemented in the root of the maxillary central incisor with resin cement. After that, root was placed in an acrylic mold, and the external end part of the post was mounted on another acrylic mold. Pull-out bond strength was measured by a universal testing machine. Results: Highest surface roughness and bond strength values were found in Group II. Conclusion: Pretreatment of GFP increases the surface roughness of post as well as bond strength of post to root dentin. There is a correlation between surface roughness and bond strength. However, the use of only universal bonding agent also showed comparable pull-out bond strength of GFP, which means only use of universal bonding agent also a new alternative as pretreatment of GFP and helps in increase in bond strength.
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Multidrug resistant Shigella is one of the leading causes of mortality in children and infants. Availability of vaccine could prevent the Shigella infection and reduce the mortality. Conventional approaches of vaccine development against shigellosis have not resulted in desirable vaccine. As shigellosis may be caused by multiple strains and serotypes, there is a need to develop a multivalent vaccine, capable of providing protection against multiple Shigella strains. To develop broad spectrum vaccine, we had previously derived a pool of conserved epitopes against Shigella by using multiple immunoinformatic tools. In this study, the identified conserved epitopes derived from the Outer Membrane Proteins A and C of Shigella were chemically synthesized, and the EpiMix made up of 5 epitopes coupled to a carrier protein, ovalbumin was developed and validated for its immunogenicity. The intramuscular immunization with EpiMix in Balb/c mice led to increase in EpiMix specific serum IgG, and significant increase in fecal IgA as well as in IL-4, IL-2and IFN-γ levels. Further, the EpiMix immunized mice showed protection when challenged against S. flexneri ATCC 12022 using the intraperitoneal route. Moreover, the analysis of cytokine profile and IFN-γ/IL4 ratio in post Shigella challenge immunized mice suggested the high levels of IFN-γ levels and possible dominance of Th1 response, playing pivotal role in the elimination of Shigella. Collectively, the results demonstrate the immunogenic potential and protective efficacy of the EpiMix in the murine shigellosis model. However, the detailed study and further optimisation of epitopes would substantiate the prospective use of EpiMix as a prophylactic candidate for vaccination.
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Aim: The aim of the study is to evaluate of debris and smear layer formation after using rotary ProTaper Universal, Twisted File, and XP Endo file systems under scanning electron microscope. Materials and Methods: Forty freshly extracted mandibular second premolar teeth were taken to decoronate at the cementoenamel junction to make the remaining root length 15 mm. Specimens were divided into four groups of 10 teeth each, Group I (control) - no instrumentation. Group II - ProTaper Universal rotary file (F2), Group III - twisted file (ISO size 0.25 and 6% taper), Group IV - XP Endo file (ISO size 0.25). During instrumentation, 5 ml normal saline was used as irrigating agent. Grooves parallel to the longitudinal axis of the root were made on the mesial and distal surface of each specimen to split it into two halves and examined under scanning electron microscope at ×1500 and ×5000 magnification. Photomicrographs were taken to evaluate debris and smear layer. Evaluation of photomicrographs was done using a score index. Results: One-way analysis of variance (ANOVA) was used to compare more than one means at a time. Tukey's critical difference followed by ANOVA was used to compare the mean values pair wise. P <0.05 was considered to be statistically significant. Among all the file systems, Group II showed maximum amount of debris (3.50 ± 1.109) followed by Group III (2.83 ± 1.238) and least amount was showed by Group IV (2.65 ± 1.122) at all levels (cervical, middle, and apical third). Among all the experimental groups, Group II showed maximum amount of smear layer (2.75 ± 1.149) followed by Group III (2.40 ± 0.982) and least amount of smear layer shown by Group IV (2.10 ± 0.841) at all levels (cervical, middle and apical third), the result was statistically significant (P < 0.05). Conclusions: At all the levels (cervical third, middle third, and apical third), among all the experimental groups, highest amount of debris and smear layer was formed by ProTaper Universal rotary file followed by Twisted file and least amount showed by XP Endo file system. In all the levels, control group showed highest amount of debris but least amount of smear layer.
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Essential thrombocythemia (ET) (primary thrombocythemia) is a nonreactive, chronic myeloproliferative clonal disorder in which sustained megakaryocyte proliferation leads to an increase in the number of circulating platelets. It is silent disorder and is diagnosed as high platelet counts with or without associated symptoms or as an accidental finding. We, hereby, report a case of ET as an incidental finding during screening of a potential platelet donor. Donors with high platelet count should be investigated properly to rule out ET. The role of transfusion medicine specialist is not only to recruit donors but also to identify such donors during screening and counsel them for detailed investigation and proper management.
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Anti-M is a relatively common "naturally occurring" antibody. Unexpected alloantibodies in patient's serum other than ABO isoagglutinins (e.g., anti-M) may cause a discrepancy in the reverse grouping. As long as anti-M does not react at 37°C, it is clinically insignificant for transfusion. However, we found this antibody to be of "immunizing" type which was reactive at 37°C and AHG phase and showing problems in blood grouping and crossmatch. This antibody had both IgM and IgG components. When "M" antibodies active at 37°C are encountered, antigen-negative or red cells that are compatible with an indirect antiglobulin test should be provided.
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Anticorpos/imunologia , Transfusão de Sangue , Leucemia Mieloide Aguda/terapia , Sistema do Grupo Sanguíneo MNSs/imunologia , Anticorpos/sangue , Feminino , Humanos , Isoanticorpos/sangue , Isoanticorpos/imunologia , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/imunologia , Pessoa de Meia-IdadeRESUMO
AIM: The aim of this study is to evaluate the surface roughness and color stability of a nanohybrid composite resin after exposure to tea, coffee, Coca-cola, and artificial saliva on the 7th, 14th, and 28th day. MATERIALS AND METHODS: Forty specimens of nanohybrid composite resin discs of dimension 6 mm × 2 mm were fabricated and were randomly divided into four equal groups based on beverages (Group 1: control group - artificial saliva, Group 2: Tea, Group 3: Coffee, and Group 4 : Coca-cola). Baseline readings of surface roughness (Ra) and color change (ΔE) were obtained by profilometer and digital image analysis technique in CIE l*a*b scale followed by the readings (ΔE) taken on the 7th, 14th, and 28th day of exposure to respective beverages. STATISTICAL ANALYSES: One-way analysis of variance (ANOVA) followed by post hoc Tukey's test and paired t-test along with Pearson's correlation with a P = 0.05. RESULTS: Overall, highest surface roughness was obtained in the samples exposed to Coca-cola followed by coffee and tea while the least surface roughness was obtained in the samples exposed to artificial saliva (control group) which was statistically significant (P < 0.05). Overall highest color change was obtained in tea followed by coffee and Coca-cola. The least color change was observed in the samples exposed to artificial saliva (control group) (P < 0.05). CONCLUSION: Surface roughness and color change were time dependent as both increased with time. Furthermore, greater the surface roughness, more was the color change observed in all the groups at all tested time intervals.
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Immunoinformatic plays a pivotal role in vaccine design and development. While traditional methods are exclusively depended on immunological experiments, they are less effective, relatively expensive, and time-consuming. However, recent advances in the field of immunoinformatics have provided innovative tools for the rational design of vaccine candidates. This approach allows the selection of immunodominant regions from the sequence of whole genome of a pathogen. The identified immunodominant region could be used to develop potential vaccine candidates that can trigger protective immune responses in the host. At present, epitope-based vaccine is an attractive concept which has been successfully trailed to develop vaccines against a number of pathogens. In this chapter, we outline the methodology and workflow of how to deploy immunoinformatics tools in order to identify immunodominant epitopes using Shigella as a model organism. The immunodominant epitopes, derived from S. flexneri 2a using this workflow, were validated using in vivo model, indicating the robustness of the outlined workflow.