Role of a modified ultrafast MRI brain protocol in clinical paediatric neuroimaging.

AIM: To establish a role for modified ultrafast magnetic resonance imaging (MRI) of the brain in clinical paediatric patients based on clinically acceptable image quality and diagnostic accuracy. MATERIALS AND METHODS: A prospective study was conducted with institutional review board approval on an ultrafast MRI brain protocol consisting of sagittal T1-weighted, axial T2-weighted, axial fluid-attenuated inversion recovery (FLAIR), axial diffusion-weighted imaging (DWI), and axial T2∗-weighted sequences. Preliminary investigations revealed that the default ultrafast T2-weighted sequence was prone to pulsation artefacts. A modified ultrafast T2-weighted sequence was therefore developed to replace the default ultrafast T2-weighted sequence. Thirty-five patients with clinical indication for neuroimaging underwent ultrafast MRI, modified ultrafast T2-weighted sequence and standard MRI at 3 T. Image quality of ultrafast MRI sequences were graded as clinically "diagnostic" or "non-diagnostic" and compared against the corresponding standard MRI sequences as the reference standard. The modified ultrafast T2-weighted sequence surpassed the default ultrafast T2-weighted sequence in image quality. The ultrafast MRI protocol was therefore replaced with the modified ultrafast T2-weighted sequence creating a modified ultrafast MRI protocol. The clinical reports of modified ultrafast MRI were compared against standard MRI for diagnostic concordance, categorised further as "normal", "clinically significant", or "clinically minor" abnormalities. RESULTS: Ultrafast T1-weighted, FLAIR, and DWI sequences had comparable image quality to standard MRI sequences. The ultrafast T2∗-weighted sequence had significantly higher non-diagnostic images (42.9%) compared to the standard MRI sequence (2.9%). The default ultrafast T2-weighted sequence had significantly higher non-diagnostic images compared to the modified ultrafast T2-weighted sequence and standard T2-weighted sequence (82.9%, 5.7%, 8.6%, respectively). There was 100% concordance for normal and clinically significant abnormalities and 23% discordance for clinically minor abnormalities. Modified ultrafast MRI takes 5 minutes 41 seconds compared to standard MRI time of 14 minutes 57 seconds. CONCLUSION: The modified ultrafast MRI protocol for brain imaging demonstrates clinically acceptable image quality in four out of five sequences and has high accuracy in diagnosing normal and clinically significant abnormalities when compared against the standard MRI protocol for brain imaging. It could potentially benefit a select group of paediatric patients who require neuroimaging.

Development of quinolone resistance and prevalence of different virulence genes among Shigella flexneri and Shigella dysenteriae in environmental water samples.

The purpose of this study was to find out the mechanism of quinolone resistance in Shigella sp. isolated from environmental water samples from various parts of Kolkata, India. Out of 196 Shigella sp. isolated from 2014 to 2017, we selected 32 Shigella isolates for antimicrobial susceptibility tests. The minimum inhibitory concentrations (MIC) for quinolones ranged from 30 to 50 µg ml-1 for ofloxacin, 5-20 µg ml-1 for ciprofloxacin and 20-30 µg ml-1 for norfloxacin. A few amino acid changes were found in quinolone resistance determining region (QRDR) of gyrA. Mutations in gyrA lead to a higher increment of MIC of quinolones. Among the plasmid-mediated (PMQR) quinolone resistance genes investigated, qnrB and aac(6')-lb-cr genes were found in all isolates. qnrA and qnrS were found in 25% and 62% of the isolates, respectively. ipaH gene was found in all of the isolates followed by the presence of other virulence genes ial, sen and stx1. Almost all the isolates having high MICs showed efflux pump activity in drug accumulation assay. All the mechanisms may or may not be present in a single strain. Several types of efflux pumps, presence of PMQR genes and mutations in drug target site of QRDR region may play the crucial role for resistance in our isolates.

Using the Engaging Parents in Education for Discharge (ePED) iPad Application to Improve Parent Discharge Experience.

PURPOSE: The purpose of this study was to evaluate the use of the Engaging Parents in Education for Discharge (ePED) iPad application on parent experiences of hospital discharge teaching and care coordination. Hypotheses were: parents exposed to discharge teaching using ePED will have 1) higher quality of discharge teaching and 2) better care coordination than parents exposed to usual discharge teaching. The secondary purpose examined group differences in the discharge teaching, care coordination, and 30-day readmissions for parents of children with and without a chronic condition. DESIGN/METHODS: Using a quasi-experimental design, ePED was implemented on one inpatient unit (n = 211) and comparison group (n = 184) from a separate unit at a pediatric academic medical center. Patient experience outcome measures collected on day of discharge included Quality of Discharge Teaching Scale-Delivery (QDTS-D) and care coordination measured by Care Transition Measure (CTM). Thirty-day readmission was abstracted from records. RESULTS: Parents taught using ePED reported higher QDTS-D scores than parents without ePED (p = .002). No differences in CTM were found between groups. Correlations between QDTS-D and CTM were small for ePED (r = 0.14, p 0.03) and non-ePED (r = 0.29, p < .001) parent groups. CTM was weakly associated with 30-day readmissions in the ePED group. CONCLUSION: The use of ePED by the discharging nurse enhances parent-reported quality of discharge teaching. PRACTICE IMPLICATIONS: The ePED app is a theory-based structured conversation guide to engage parents in discharge preparation. Nursing implementation of ePED contributes to optimizing the patient/family healthcare experience.

Engaging Parents in Education for Discharge (ePED): Evaluating the Reach, Adoption & Implementation of an Innovative Discharge Teaching Method.

PURPOSE: This paper describes the evaluation of the implementation of an innovative teaching method, the "Engaging Parents in Education for Discharge" (ePED) iPad application (app), at a pediatric hospital. DESIGN AND METHODS: The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation. Three of the five RE-AIM elements are addressed in this study: Reach, Adoption, and Implementation. RESULTS: The Reach of the ePED was 245 of 1015 (24.2%) patient discharges. The Adoption rate was 211 of 245 (86%) patients discharged in the five months' study period. High levels of fidelity (89.3%) to Implementation of the ePED were attained: the Signs and Symptoms domain had the highest (93%) and Thinking Forward about Family Adjustment screen had the lowest fidelity (83.3%). Nurse themes explained implementation fidelity: "It takes longer", and "Forgot to do it." CONCLUSIONS: The ePED app operationalized how to have an engaging structured discharge conversation with parents. While the Reach of the ePED app was low under the study conditions, the adoption rate was positive. Nurses were able to integrate a theory-driven practice change into their daily routine when using the ePED app. IMPLICATIONS FOR PRACTICE: The rates of adoption and implementation fidelity support the feasibility of future hospital wide implementation to improve patient and family healthcare experience. Attention to training of new content and the interactive conversation approach will be needed to fully leverage the value of the ePED app. Future studies are needed to evaluate the maintenance of the ePED app.

Prevalence and associated factors of Carpal Tunnel Syndrome (CTS) among medical laboratory staff at King Saud University Hospitals, KSA.

BACKGROUND AND OBJECTIVES: Carpal tunnel syndrome (CTS) is a group of symptoms resulting from local compression of the median nerve at the wrist leading to its subsequent functional impairment and local ischemia of the nerve. Our objective was to determine the prevalence and commonly reported symptoms of CTS in the laboratory workers of King Saud University (KSU) hospitals and to identify the associated variables with CTS. METHODS: This was a quantitative observational cross-sectional study which was conducted in KSU hospitals' laboratories with a total of 225 participants by using a standardized questionnaire known as " Boston Carpal Tunnel Questionnaire (BCTQ). Data Analysis was carried out by IBM SPSS Statistics software version 21.0. RESULTS: Out of the 225 participants, 57 were found to be severely symptomatic with a prevalence of 25.3%. Among the severely affected participants, females were more than males (58% > 42%) and the difference was statistically significant (p=0.045). Technicians affected (91.2%) were more than attendants (8.8%) and the difference was statistically significant (p=0.042). CONCLUSION: The prevalence of Carpal tunnel syndrome in KSU hospitals' medical laboratory staff (25.3%) was close to what was found in literature (21.5%). So laboratory workers are at risk of developing CTS, especially females and technicians with the dominant hand most likely to be affected.

Hyponatraemia in older medical patients: implications for falls and adverse outcomes of hospitalisation.

BACKGROUND: Recent evidence suggests an association between hyponatraemia and falls. AIMS: To determine the association of hyponatraemia with admission-associated falls (i.e. falls as part of the presenting complaint or during admission) and predefined adverse outcomes of hospitalisation. METHODS: A case-control study of patients aged ≥65 years admitted with hyponatraemia during a 6-month period was conducted. The relevant data were collected by review of medical records and analysed in univariate and multivariate models. RESULTS: The prevalence of hyponatraemia was 22% and more likely to be associated with the admission diagnoses of cardiovascular (P = 0.04) and metabolic disorders (P < 0.001), use of diuretics (P = 0.037) and a higher Charlson comorbidity score (P = 0.035). Hyponatraemia was independently associated with admission-associated falls (odds ratio (OR) 3.12, confidence interval (CI) 1.84-4.38, P < 0.001). The increased odds of falling were similar for mild (OR 3.15, CI 1.75-5.66) vs moderate to severe hyponatraemia (OR 3.07, CI 1.57-6.03). Although hyponatraemia had a significant independent association with increased length of stay (LOS) (OR 1.48, CI 1.22-1.79, P < 0.001) and change in residential care status to a more dependent category at discharge (OR 4.28, CI 1.68-10.859, P = 0.002), it was not associated with mortality or time to first unplanned readmission. Hyponatraemia was significantly associated with the need for inpatient rehabilitation; however, this was no longer significant when adjusted for falls. CONCLUSION: Hyponatraemia is independently associated with increased risk of admission-associated falls. The degree of falls risk is similar regardless of the severity of hyponatraemia. Hyponatraemia is also an important determinant of many adverse outcomes of hospitalisation.

Better physical activity classification using smartphone acceleration sensor.

Obesity is becoming one of the serious problems for the health of worldwide population. Social interactions on mobile phones and computers via internet through social e-networks are one of the major causes of lack of physical activities. For the health specialist, it is important to track the record of physical activities of the obese or overweight patients to supervise weight loss control. In this study, acceleration sensor present in the smartphone is used to monitor the physical activity of the user. Physical activities including Walking, Jogging, Sitting, Standing, Walking upstairs and Walking downstairs are classified. Time domain features are extracted from the acceleration data recorded by smartphone during different physical activities. Time and space complexity of the whole framework is done by optimal feature subset selection and pruning of instances. Classification results of six physical activities are reported in this paper. Using simple time domain features, 99 % classification accuracy is achieved. Furthermore, attributes subset selection is used to remove the redundant features and to minimize the time complexity of the algorithm. A subset of 30 features produced more than 98 % classification accuracy for the six physical activities.

Effect of Fathers in Preemie Prep for Parents (P3) Program on Couple's Preterm Birth Preparedness.

Objective: Evaluate the effect of fathers' participation in the Preemie Prep for Parents (P3) program on maternal learning and fathers' preterm birth knowledge. Methods: Mothers with preterm birth predisposing medical condition(s) enrolled with or without the baby's father and were randomized to the P3 intervention (text-messages linking to animated videos) or control (patient education webpages). Parent Prematurity Knowledge Questionnaire assessed knowledge, including unmarried fathers' legal neonatal decision-making ability. Results: 104 mothers reported living with the baby's father; 50 participated with the father and 54 participated alone. In the P3 group, mothers participating with the father (n=33) had greater knowledge than mothers participating alone (n=21), 85% correct responses vs. 76%, p =0.033. However, there was no difference in knowledge among the control mothers, 67% vs. 60%, p =0.068. P3 fathers (n=33) knowledge scores were not different than control fathers (n=17), 77% vs. 68%, p =0.054. Parents who viewed the video on fathers' rights (n=58) were more likely than those who did not (n=96) to know unmarried fathers' legal inability to decide neonatal treatments, 84% vs. 41%, p <0.001. Conclusions: Among opposite-sex cohabitating couples, fathers' participation in the P3 program enhanced maternal learning. Practice Implications: The P3 program's potential to educate fathers may benefit high-risk pregnancies.

Black Women and the Preemie Prep for Parents (P3) Program: Exploratory Analysis of a Clinical Trial.

Background: The smartphone Preemie Prep for Parents (P3) program was developed to address the gap in prenatal education of preterm birth in high-risk pregnancies. Despite a higher incidence of preterm birth, Black women are less likely to receive prenatal education. Methods: Pregnant women with medical conditions that predisposed them to preterm birth were randomized to receive the P3 program or links to American College of Obstetricians and Gynecologists webpages (control). The P3 group received periodic text messages, starting as early as 18 weeks gestational age, each with a link to a short, animated educational video. Participants completed the Parent Prematurity Knowledge Questionnaire, PROMIS Anxiety scale, and a feedback survey. This is a subgroup analysis of the Black, non-Hispanic participants in the P3 trial. Results: Of the 26 Black non-Hispanic women enrolled, the P3 group (n=14) had higher knowledge scores than the control group (n=12), 67.5% correct vs. 43.6% (difference 24.0; 95% CI, 7.4 to 40.6), without experiencing an increase in anxiety. More P3 participants reported discussing preterm birth with their partner (100%) than control participants (57%; difference 43; 95% CI, 6 to 80). Conclusions: The P3 program appears to be an effective method of providing preterm birth education to Black pregnant women.

Hookworm infection induces glycometabolic modulation in South Indian individuals with type 2 diabetes.

Objectives: A number of epidemiological studies have demonstrated that there is an inverse relationship between helminth infections and diabetes mellitus, suggesting that helminth infection may have a positive effect on type 2 diabetes mellitus (T2DM). However, the association between hookworm infection and T2DM has barely been studied. Hence, we aimed to investigate and analyze the interaction and association between hookworm infection and T2DM. Methods: We examined the effect of hookworm infection on biochemical parameters, including plasma random blood glucose, glycated hemoglobin, and the plasma levels of pancreatic hormones, incretins, and adipokines in individuals with T2DM with (INF, n = 35) or without (UN, n = 35) hookworm infection. Moreover, we re-evaluated these analyte concentrations in a subset of INF individuals 6 months following anthelmintic therapy. Results: Compared to UN individuals, INF individuals had significantly lowered levels of random blood glucose and glycated hemoglobin. INF individuals also exhibited significantly diminished levels of adiponectin, adipsin, C-peptide, insulin, and glucagon compared to UN individuals. In contrast, INF individuals displayed substantially elevated levels of visfatin and incretins compared to UN individuals. Interestingly, this effect was not seen following anthelmintic treatment. Conclusion: Our study findings indicate that concomitant hookworm infection exerts a beneficial effect on glycometabolic parameters in T2DM.

Characterizations of novel broad-spectrum lytic bacteriophages Sfin-2 and Sfin-6 infecting MDR Shigella spp. with their application on raw chicken to reduce the Shigella load.

The evidence and prevalence of multidrug-resistant (MDR) Shigella spp. poses a serious global threat to public health and the economy. Food- or water-borne MDR Shigella spp. demands an alternate strategy to counteract this threat. In this regard, phage therapy has garnered great interest from medical practitioners and researchers as a potential way to combat MDR pathogens. In this observation, we isolated Shigella phages from environmental water samples and tested against various clinically isolated MDR Shigella spp. In this study, we have defined the isolation and detailed physical and genomic characterizations of two phages Sfin-2 and Sfin-6 from environmental water samples. The phages exhibited potent lytic activity against Shigella flexneri, Shigella dysenteriae, and Shigella sonnei. They showed absorption within 5-10 min, a burst size ranging from ~74 to 265 PFU/cell, and a latent period of 5-20 min. The phages were stable at a broad pH range and survived an hour at 50°C. The purified phages Sfin-2 and Sfin-6 belong to the Siphoviridae family with an isometric head (64.90 ± 2.04 nm and 62.42 ± 4.04 nm, respectively) and a non-contractile tail (145 ± 8.5 nm and 148.47 ± 14.5 nm, respectively). The in silico analysis concluded that the size of the genomic DNA of the Sfin-2 phage is 50,390 bp with a GC content of 44.90%, while the genome size of the Sfin-6 phage is 50,523 bp with a GC content of 48.30%. A total of 85 and 83 putative open reading frames (ORFs) were predicted in the Sfin-2 and Sfin-6 phages, respectively. Furthermore, a comparative genomic and phylogenetic analysis revealed that both phages represented different isolates and novel members of the T1-like phages. Sfin-2 and Sfin-6 phages, either individually or in a cocktail form, showed a significant reduction in the viable Shigella count on raw chicken samples after 72 h of incubation. Therefore, these results indicate that these phages might have a potential role in therapeutic approaches designed for shigellosis patients as well as in the biological control of MDR Shigella spp. in the poultry or food industry during the course of meat storage.

Smartphone-Based Video Antenatal Preterm Birth Education: The Preemie Prep for Parents Randomized Clinical Trial.

Importance: Preterm birth is a leading cause of infant mortality and child morbidity. Preterm birth is not always unexpected, yet standard prenatal care does not offer anticipatory education to parents at risk of delivering preterm, which leaves parents unprepared to make health care choices during the pregnancy that can improve survival and decrease morbidity in case of preterm birth. Objective: To evaluate the effect of the Preemie Prep for Parents (P3) program on maternal knowledge of preterm birth, preparation for decision-making, and anxiety. Design, Setting, and Participants: Recruitment for this randomized clinical trial conducted at a US academic medical center took place from February 3, 2020, to April 12, 2021. A total of 120 pregnant persons with a risk factor for preterm birth were enrolled between 16 and 21 weeks' gestational age and followed up through pregnancy completion. Intervention: Starting at 18 weeks' gestational age, P3 program participants received links delivered via text message to 51 gestational age-specific short animated videos. Control participants received links to patient education webpages from the American College of Obstetricians and Gynecologists. Main Outcomes and Measures: At 25 weeks' gestation, scores on the Parent Prematurity Knowledge Questionnaire (scored as percent correct), Preparation for Decision Making Scale (scored 0-100), and Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety computerized adaptive test. Analysis was based on an intention to treat. Results: A total of 120 pregnant participants (mean [SD] age, 32.5 [4.9] years) were included in the study; 60 participants were randomized to each group. Participants in the P3 group scored higher than those in the control group on knowledge of long-term outcomes at 25 weeks (88.5% vs 73.2%; estimated difference, 15.3 percentage points; 95% CI, 8.3-22.5 percentage points; P < .001). Participants in the P3 group reported being significantly more prepared than did participants in the control group for neonatal resuscitation decision-making at 25 weeks (Preparation for Decision Making Scale score, 76.0 vs 52.3; difference, 23.7; 95% CI, 14.1-33.2). There was no difference between the P3 group and the control group in anxiety at 25 weeks (mean [SE] PROMIS Anxiety scores, 53.8 [1.1] vs 54.0 [1.1]; difference, -0.1; 95% CI, -3.2 to 2.9). Conclusions and Relevance: In this randomized clinical trial, pregnant persons randomly assigned to the P3 program had more knowledge of core competencies and were more prepared to make decisions that affect maternal and infant health, without experiencing worse anxiety. Mobile antenatal preterm birth education may provide a unique benefit to parents with preterm birth risk factors. Trial Registration: ClinicalTrials.gov Identifier: NCT04093492.

Impacts of Dietary Lysine and Crude Protein on Performance, Hepatic and Renal Functions, Biochemical Parameters, and Histomorphology of Small Intestine, Liver, and Kidney in Broiler Chickens.

The present study aimed to investigate the effects of increasing dietary lysine (Lys) levels with an adequate dietary crude protein (CP) content, as well as the effects of a reduction in dietary CP content with the recommended amino acid (AAs) level, on the performance, blood biochemical parameters, and histomorphology of the duodenum, liver, and kidney in broiler chickens. A total of 500 broiler chickens were randomly distributed into five dietary treatment groups, following a completely randomized design, where, at the beginning, the control group (C) was fed a diet containing the standard CP and Lys levels: 23% CP with 1.44% Lys during the starter period; 21.5% CP with 1.29% Lys during the growing period; and 19.5% CP with 1.16% Lys during the finishing period. The Lys content was increased by 10% above the recommended control basal requirements in the second group (Gr1) and by 20% in the third group (Gr2), while using the same recommended CP percentage as the C group. The fourth group (Gr3) had a 1% lower CP content and the fifth group had a 2% lower CP content than the C group, with the same recommended AA level as the C group. Increasing the Lys content in the Gr1 group improved the broilers' weight gains (p < 0.05) during the starter, growing, and finishing periods. Decreasing dietary CP with the standard AA levels (Gr3 and Gr4) did not significantly affect (p > 0.05) the live weight gain, feed intake, or feed conversion ratio (FCR) of the broilers compared with those fed with the C diet. Blood total bilirubin, direct and indirect bilirubin, triglycerides, cholesterol, low-density lipoprotein (LDL), and very LDL were not different among the experimental groups. However, blood aspartate aminotransferase levels were increased (p < 0.05) in the Gr1 and Gr3 groups compared with the other treatment groups. All dietary treatments decreased the serum creatinine levels (p < 0.05) compared with the C group. The Gr2 broilers had greater serum total protein and globulin (p < 0.05) than those receiving the other treatments. Increasing dietary Lys levels resulted in a significant improvement in duodenum villus height and width (p < 0.05), while the low-CP diets resulted in shorter villi length and width, along with degenerated areas and lymphocytic infiltration. Low dietary CP content induced hepatocyte disorganization and moderate degeneration, along with vacuolated hepatic cells, excessive connective tissue, and lymphocytic infiltration. The cortical regions of the kidney exhibited obvious alterations in the Gr3 and Gr4 groups and large interstitial spaces were found between tubules. Renal tubules in the Gr3 and Gr4 groups were smaller in size and some of these tubules were atrophied. In conclusion, reducing dietary CP levels to 1% or 2% lower than the recommended level did not negatively affect growth performance, inducing minimal influence on the blood metabolic indicators of health status, and resulting in moderate alterations to the histomorphology of the duodenum, liver, and kidney. Furthermore, increasing the Lys content by 10% above the recommended level improved the growth performance, health status, and histomorphology of the duodenum, liver, and kidney in broiler chickens.

Evaluation of Central Obesity, Increased Body Mass Index, and its Relation to Oropharyngeal Airway Space Using Lateral Cephalogram in Risk Prediction of Obstructive Sleep Apnea.

INTRODUCTION: Maxillofacial radiologists play a significant role in detecting airway changes using radiographic tools. Clinical examination parameters and lateral cephalogram parameters play a vital role in diagnosing obstructive sleep apnea (OSA) and dreadful consequences. AIM AND OBJECTIVES: This study aims to evaluate central obesity, increased body mass index (BMI), and its relation to oropharyngeal airway space using lateral cephalogram in risk prediction of OSA. Objectives are to measure central obesity and BMI. METHODOLOGY: BMI is measured using World Health Organization guidelines to measure oropharyngeal airway space and the tongue and soft palate area using lateral cephalogram to predict OSA's risk using Berlin's questionnaire. Age group between 18 and 60 years with 20 individuals in each group will be present in the study. CONCLUSION: Cephalometric upper airway space and soft-tissue variables in different BMI groups were compared, and it was found that there was a decrease in SPAS, MAS with an increase in BMI, and in patients with BMI <24, there was narrower nasopharynx and oropharynx.

Effect of root dentin conditioning using different chelating agents on pushout bond strength of MTA-fillapex and bioroot RCS: An in vitro study.

CONTEXT: The success of endodontic therapy depends on proper biomechanical preparation and obturation. AIM: To evaluate and compare the pushout bond strength (POBS) of MTA Fillapex (MF) and BioRoot RCS (BRCS) sealers in endodontically treated teeth with different irrigants-5.25% Sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA) and 0.2% Chitosan. MATERIALS AND METHODS: 60 premolars were divided into three groups. Each group was then subdivided into A and B. The three groups were Group 1A: 17% EDTA + 5.25% NaOCl with MF sealer (n = 10); Group 1B: 17% EDTA + 5.25% NaOCl with BRCS sealer (n = 10); Group 2A: 0.2% Chitosan + 5.25% NaOCl with MF sealer (n = 10); Group 2B: 0.2% Chitosan + 5.25%NaOCl with BRCS sealer (n = 10); Group 3A: 5.25% NaOCl + MF sealer (n = 10); and Group 3B: 5.25% NaOCl + BRCS sealer (n = 10). After obturation, they were sectioned horizontally (1.5 mm thick). The POBS was studied using a universal testing machine (Autograph AG-1). The sample size was calculated using the statistical package G * Power (3.1.5). RESULTS: It was found that the POBS of BRCS was higher when the root canal was irrigated with 0.2% Chitosan + 5.25% NaOCl. Thus, Group 2B showed significantly higher POBS than Group 2A. CONCLUSION: The irrigation regimen of Chitosan with NaOCl was found to have better debriding effect on the root canal. Of the two sealers, BRCS showed the higher bond strength values than MF.

Comparative evaluation of body mass index among school children with and without Bruxism of age group of 6-12 years in Kanchipuram district: A cross-sectional study.

AIM: To evaluate and compare the body mass index (BMI) of school-going children with bruxism and without bruxism of age between 6 and 12 years. SETTINGS AND DESIGN: To find the correlation between BMI and oral habit bruxism among school children and compare with those children without bruxism. MATERIALS AND METHODS: A total of 6122 children were screened from 28 government and 12 private schools, in which 1854 (30.28%) had various types of oral habits. Among this 280 children had the stressful habit bruxism. The BMI of those children was calculated by measuring the height and weight. The values were compared with the BMI of same number of students of same age group, who does not have any oral habits, with the WHO standard. The values were calculated and tabulated for the statistical analysis, using the SPSS software version 19 (IBM company) with the P < 0.05 as statistically significant. RESULTS: Its shows that children with bruxism has high BMI range, was in the order of overweight > Normal > Underweight, but the BMI of children without any habit was in the order of normal > Underweight > Overweight. On comparison, it was statistically significant. CONCLUSION: The habit bruxism had a positive correlation with the BMI of children. The children are more stressed from both indoor and outdoor. Hence, kindly educate all the parents, teachers, and public to identify the cause for the habit, because each oral habit is strongly deep rooted with some emotional and/or psychological problem and to make the children stress free in future.

Atypical presentation of non-ossifying fibroma.

Non-ossifying fibroma is a common benign bone lesion but extensive involvement of almost whole of the shaft of right tibia is a rare presentation. The patient was a young lady of 35 years admitted at the department of Orthopaedics in Bangabandhu Sheikh Mujib Medical University (BSMMU) on June 2006 with pain and swelling of right distal tibia and unable to walk without support, was diagnosed clinico-radiologically as a case of fibrous dysplasia. The lady was undergone surgery and biopsy confirmed a case of non-ossifying fibroma. Within the follow up period of 28 months, the patient was well with full functional limb and the lesion was also healed radiologically.

Application of mixed bone graft (autograft+allograft) in the management of giant cell tumor of bone.

Giant cell tumor is a common bone neoplasm. We have initiated a prospective study for the treatment of giant cell tumor of bone by mixed (Autograft+Allograft) bone graft in the department of orthopaedics, Bangabandhu Sheikh Mujib Medical University (BSMMU), during January 2002 to March 2008. A total 28 patients of giant cell tumor of bone were operated. In this study out of 28 cases, male were 11(39.28%) and female were 17(60.72%). Female were predominant. Age of the patients ranging from 11 years to 49 years, mean age 27.03 years. More common in 21 years to 30 years 16(57.14%) of cases. Common sites of lesion were distal & proximal end of femur 11(39.28%), proximal end of tibia 6(21.43%), proximal humerus 3(10.71%) and distal radius 3(10.71%). Final clinical outcome of giant cell tumor of bone treated by thorough curettage of the cavity and filled with mixed bone graft (freeze dried radiation sterilized bone allograft+autogenous bone graft) in which success rate is 75%(21) and recurrence rate is 25%(7). P is <0.001. Follow up period was 4 months to 4 years. From this study it was realized that mixed bone graft is useful graft material for enhancing osteogenic potential as well as maintaining structural integrity for the treatment of giant cell tumor of bone.