Changes in essential salivary parameters in patients undergoing fixed orthodontic treatment: A longitudinal study.

OBJECTIVE: Orthodontic treatment using fixed appliances is known to alter the oral environment and encourage plaque retention around orthodontic brackets and bands, resulting in enamel demineralization and gingival inflammation. This study aimed to evaluate the changes in essential salivary parameters in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: Saliva samples were collected from 60 patients before and 2 months after commencing fixed orthodontic treatment. The salivary flow rate, pH, buffering capacity, and levels of amylase, total protein, and glucose were determined. Parametric and nonparametric tests for paired samples were used for comparing the mean differences before and after commencing treatment. RESULTS: Significant reductions in the salivary flow rate, pH, and buffering capacity were noted 2 months after commencing treatment (P < 0.05). Total protein concentrations and calcium levels decreased significantly and amylase and glucose levels increased after commencing treatment (P < 0.05). Significant correlations were observed between salivary total protein concentrations and buffering capacity as well as calcium levels (P < 0.05). CONCLUSION: These findings indicate that the biochemical properties of saliva are altered after introducing fixed orthodontic appliances into the oral cavity, thereby promoting plaque retention and increasing the susceptibility to tooth demineralization and gingival inflammation.

Role of Nuclear Morphometry in the Cytologic Evaluation of Benign and Malignant Thyroid Lesions.

Thyroid lesions are very common problem in Bangladesh. To categorize the type of lesion, FNAC is a reliable, minimally invasive and cost-effective diagnostic modality. In routine cytology, precise categorization into benign and malignant is highly subjective. So, additional methods are needed to improve the accuracy of cytological diagnosis. Computerized semi-automatic nuclear morphometry is an objective and reproducible tool for quantitative evaluation of nuclear features which may help to differentiate between benign and malignant thyroid lesions in cytology. Objective of the study was to apply morphometry with regard to nuclear size parameters, shape parameters and nuclear chromasia with derivation of suitable cutoff values to differentiate benign and malignant lesions of thyroid gland. This cross-sectional study was done in total 55 cases at the Department of Pathology, Bangabandhu Sheikh Mujib Medical University, Bangladesh from March 2018 to February 2020. Morphometry was done on images containing diagnostic cells captured from cytological smears with open source ImageJ morphometric software. In this study, all the nuclear size parameters and one nuclear shape parameter was found significant in differentiating benign and malignant lesions. No significant difference was observed in analysis of chromasia parameter. The cut-off values derived between all benign and malignant lesions for mean value of nuclear area, maximum feret diameter, perimeter and aspect ratio were 40.20µm², 8.46µm, 6.68µm, 28.28µm and 1.35 respectively with sensitivity of 86%, 95%, 81%, 90% and specificity of 97%, 93%, 97% and 97% respectively. The Nuclear morphometry may be used as an adjunctive tool to routine thyroid cytology.

The influence of dose and ethnic origins on the pharmacokinetics of nifedipine.

The pharmacokinetics of nifedipine capsules was investigated in healthy young Caucasian and South Asian subjects. Both the area under the plasma concentration-time curve (AUC) and terminal half-life of nifedipine were significantly higher in South Asians compared with Caucasian subjects after single oral doses of 10 and 20 mg. The AUC and half-life values of the nitropyridine metabolite were also higher in South Asians than in Caucasian subjects. The serum protein binding of nifedipine was similar in the two groups. The pharmacokinetics were essentially linear in both Caucasian subjects (0 to 30 mg; n = 27) and South Asians (0 to 20 mg; n = 16). There was no indication of a separate subgroup of Caucasian subjects with high AUC values equivalent to the poor metabolizers reported previously. Pharmacodynamic modeling for South Asians gave estimates comparable to those previously reported in Caucasian subjects. Patients of South Asian origin may require lower doses of nifedipine.

Anomalous left coronary artery from the pulmonary artery: creating an autogenous arterial conduit for aortic implantation.

Anomalous origin of the left coronary artery from the pulmonary artery requires surgical correction. A surgical technique is presented. Two infants underwent re-implantation of their anomalous left coronary arteries by creating a tunnel using autogenous aortic and pulmonary arterial walls. The advantage of this technique is that the new left coronary artery lies in the horizontal plane and in an anatomically correct axis running in the groove behind the pulmonary artery. It also provides a tension free endothelialized autogenous arterial walls with normal growth anticipated.

The use of intra aortic baloon pump in patients undergoing coronary artery bypass grafting at the Aga Khan University Hospital, Karachi.

OBJECTIVE: To review the experience in the use of Intra Aortic Balloon Pump (IABP) in patients undergoing Coronary Artery Bypass Grafting (CABG) at a tertiary care hospital with a new Open Heart surgery program. DESIGN: Retrospective study. SETTING: The Aga Khan University Hospital, Karachi. PATIENTS: Medical records of all patients undergoing CABG between November 1994 and July 1997 were reviewed and those in whom IABP device was used, were included in this study. RESULTS: A total of 15 patients had IABP support during the study period. Four surgeries were done urgently while two were emergencies. There were three mortalities. Ejection fractions in all but one patient were impaired. Among the surviving patients, the average pre-IABP Cardiac Index was 2.6 litres/min/meter2 which registered an average increase of 21.15% after the initiation of the IABP. The Pulmonary Artery Wedge Pressure also showed an average reduction of 29.11% from the pre IABP levels reflecting an increase in the cardiac output with the use of the IABP. CONCLUSION: This series represents the early experience of a new cardiac surgery center in Pakistan in the use of IABP. Although the numbers in this study are too small to derive any conclusions, the overall morbidity and mortality in this short series are within acceptable limits in the high risk patients included.

Effect of treated tannery effluent with domestic wastewater and amendments on growth and yield of cotton.

Pot culture and field experiments were carried out at the Common Effluent Treatment Plant (CETP), Dindigul during kharif 2011-12 to investigate the influence of irrigation of treated tannery effluent along with domestic wastewater on growth, yield attributes and yield of cotton. The pot culture was in a factorial completely randomized design and field experiment laid out in factorial randomized block design with four replications. The results revealed that the mixing proportion of 25% Treated Tannery Effluent (TTE)+75% domestic wastewater (DWW) application recorded taller plants, higher dry matter production, number of sympodial branches plant(-1), number of fruiting points plant(-1), number of bolls plant(-1) and seed cotton yield with yield reduction of 15.28 and 16.11% compared to normal water irrigation under pot culture and field experiment, respectively. Regarding amendments, gypsum application registered higher seed cotton yield followed by VAM.

Towards an anatomically correct repair for anomalous left coronary artery arising from the pulmonary trunk.

BACKGROUND: Anomalous origin of the left coronary artery from the pulmonary trunk is rare, occurring at an incidence of 1 in 300,000. If not diagnosed and treated early, it is life-threatening. Children with the anomaly usually present in infancy with congestive cardiac failure, and are occasionally referred for cardiac transplant. We investigated the medium term outcome for patients following creation of a two-coronary arterial circulation. METHODS: Between 1992 and 2007, we diagnosed 15 patients seen at our Institution as having anomalous origin of the left coronary artery from the pulmonary trunk. Over a period of 13 years, aortic reimplantation was undertaken in 12 of these patients, who form the studied cohort. RESULTS: Direct reimplantation was performed in 5 patients. In 3 cases, a tension-free anastomosis was created using a caudally based flap. In another 3 cases, an extended flap was used, while a patch arterioplasty was fashioned in the final patient. There were no deaths. Left ventricular function recovered in all but one of the patients, and all patients had a reduction in the degree of mitral regurgitation. CONCLUSIONS: Among the variety of surgical techniques, transfer of the anomalous left coronary artery to the aorta is the ideal method for long-term patency and adequate blood supply. This can be achieved by creating flaps based on the walls of the pulmonary trunk and aorta, producing a dual coronary arterial supply with no mortality and low morbidity.