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1.
Eur J Prosthodont Restor Dent ; 32(2): 153-161, 2024 May 31.
Article in English | MEDLINE | ID: mdl-38299373

ABSTRACT

INTRODUCTION: Digital dentistry and advanced ceramic materials have been widely used but which material has a better esthetically durable outcome needs to be evaluated. The purpose of this systematic review and meta-analysis was to evaluate the difference in the translucency of CAD zirconia-reinforced lithium silicate and CAD lithium disilicate glass ceramics after being subjected to artificial aging. MATERIAL AND METHODS: Two independent reviewers searched the MEDLINE/ PubMed, Embase, and EBSCO databases and the Google Scholar search engine for in-vitro studies published from January 2010 to May 2023 to identify relevant studies measuring the translucency of CAD ZLS and CAD lithium disilicate glass ceramics after being subjected to different artificial aging conditions using the coffee solution, 4% acetic acid, distilled water and UV aging. RESULTS: For qualitative synthesis, 10 studies were included. A statistically significant difference was observed between CAD zirconia-reinforced lithium silicate and CAD lithium disilicate glass ceramics (P⟨0.05, mean difference=-0.25 [-0.38,-0.11]). Translucency of CAD ZLS was less than CAD lithium disilicate glass ceramics. CONCLUSIONS: Artificial aging has decreased the translucency of glass ceramics. For fixed prosthetic rehabilitation clinicians can opt for CAD lithium disilicate glass-ceramic as a more esthetically pleasing and durable material in oral environment.


Subject(s)
Ceramics , Dental Porcelain , Silicates , Zirconium , Dental Porcelain/chemistry , Zirconium/chemistry , Ceramics/chemistry , Silicates/chemistry , Computer-Aided Design , Humans , Materials Testing , Dental Materials/chemistry
2.
Vaccine ; 41(48): 7250-7258, 2023 11 22.
Article in English | MEDLINE | ID: mdl-37903680

ABSTRACT

OBJECTIVES: We evaluated the frequency of moderate and severe adverse events following coadministration of seasonal influenza vaccine (SIV) versus placebo with COVID-19 vaccines among adults to support practice guidelines. METHODS: FluVID is a participant-blinded, phase IV, randomised control trial. On the same day as the participant's scheduled COVID-19 vaccine, participants were randomised to receive SIV or saline placebo; those assigned placebo at visit one then received SIV a week later, and vice versa. Self-reported adverse events were collected daily for seven days following each visit. The primary endpoint was any solicited adverse event of at least moderate severity occurring up to seven days following receipt of SIV or placebo. This was modelled using a Bayesian logistic regression model. Analyses were performed by COVID-19 vaccine type and dose number. RESULTS: Overall, 248 participants were enrolled; of these, 195 had received BNT162b2 and 53 had received mRNA1273 COVID-19 vaccines according to national guidelines. After randomisation, 119 were assigned to receive SIV and 129 were assigned to receive placebo at visit one. Adverse events were most frequently reported as mild (grade 1) in nature. Among 142 BNT162b2 booster dose one and 43 BNT162b2 booster dose two recipients, the posterior median risk difference for moderate/severe adverse events following SIV versus placebo was 13% (95% credible interval [CrI] -0.03 to 0.27) and 13% (95%CrI -0.37 to 0.12), respectively. Among 18 mRNA1273 booster dose one and 35 mRNA1273 booster dose two recipients, the posterior median risk difference of moderate/severe adverse events following influenza vaccine versus placebo was 6% (95%CrI -0.29 to 0.41) and -4% (95%CrI -0.30 to 0.23), respectively. CONCLUSION: Adverse events following SIV and COVID-19 co-administration were generally mild and occurred with similar frequency to events following COVID-19 vaccine alone. We found no evidence to justify routine separation of SIV and COVID-19 vaccine doses. CLINICAL TRIAL REGISTRATION: ACTRN12621001063808.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Adult , Humans , COVID-19 Vaccines/adverse effects , Influenza, Human/prevention & control , COVID-19/prevention & control , BNT162 Vaccine , Bayes Theorem , Seasons , Double-Blind Method
3.
Pulmonology ; 29(2): 124-129, 2023.
Article in English | MEDLINE | ID: mdl-33408042

ABSTRACT

BACKGROUND: Latent tuberculosis infection (LTBI) diagnosis in a country with a low tuberculosis burden is complicated. Since the prevalence of LTBI in second generation immigrants has not been well recognized, we conducted a cross-sectional study which aimed to explore the differences in LTBI prevalence between offspring of immigrants from high tuberculosis (TB) burden countries and those whose parents were born in countries with a low TB burden. METHODS: Between May 2014 and April 2018 young native Israelis who were required to perform pre-occupational tuberculin skin tests (TST) (medical and paramedical personnel or teaching assistants of immigrants from high TB burden countries) and who had a TST result of 10mm and above were tested for QuantiFERON-TB In Tube (QFT-GIT). Statistical comparisons were made between second generation immigrants and those with both parents from a low TB burden country. RESULTS: Of 102 patients, 71 were born to parents both of whom were from low-risk countries, 14 to one parent from a high-risk country and 17 to parents both of whom were from a high-risk country. The odds ratio for LTBI was 4.5 (95% CI, 1.2...17.2; p=0.03) if both parents were born in a high-risk country compared to both parents being from a low-risk country and 4.01 (95% CI, 1.12...14.3; p=0.03) higher compared to persons for whom at least one parent was born in a low-risk country. CONCLUSION: The risk for latent TB is significantly higher in second generation immigrants if both parents were born in a high-risk country. IGRA should be considered before treatment to patients with a positive TST if at least one parent was born in a low-risk country in order to confirm LTBI.


Subject(s)
Emigrants and Immigrants , Latent Tuberculosis , Tuberculosis , Humans , Latent Tuberculosis/diagnosis , Latent Tuberculosis/epidemiology , Prevalence , Cross-Sectional Studies , Tuberculosis/epidemiology
4.
RMD Open ; 8(2)2022 09.
Article in English | MEDLINE | ID: mdl-36104117

ABSTRACT

OBJECTIVE: We investigated prolonged COVID-19 symptom duration, defined as lasting 28 days or longer, among people with systemic autoimmune rheumatic diseases (SARDs). METHODS: We analysed data from the COVID-19 Global Rheumatology Alliance Vaccine Survey (2 April 2021-15 October 2021) to identify people with SARDs reporting test-confirmed COVID-19. Participants reported COVID-19 severity and symptom duration, sociodemographics and clinical characteristics. We reported the proportion experiencing prolonged symptom duration and investigated associations with baseline characteristics using logistic regression. RESULTS: We identified 441 respondents with SARDs and COVID-19 (mean age 48.2 years, 83.7% female, 39.5% rheumatoid arthritis). The median COVID-19 symptom duration was 15 days (IQR 7, 25). Overall, 107 (24.2%) respondents had prolonged symptom duration (≥28 days); 42/429 (9.8%) reported symptoms lasting ≥90 days. Factors associated with higher odds of prolonged symptom duration included: hospitalisation for COVID-19 vs not hospitalised and mild acute symptoms (age-adjusted OR (aOR) 6.49, 95% CI 3.03 to 14.1), comorbidity count (aOR 1.11 per comorbidity, 95% CI 1.02 to 1.21) and osteoarthritis (aOR 2.11, 95% CI 1.01 to 4.27). COVID-19 onset in 2021 vs June 2020 or earlier was associated with lower odds of prolonged symptom duration (aOR 0.42, 95% CI 0.21 to 0.81). CONCLUSION: Most people with SARDs had complete symptom resolution by day 15 after COVID-19 onset. However, about 1 in 4 experienced COVID-19 symptom duration 28 days or longer; 1 in 10 experienced symptoms 90 days or longer. Future studies are needed to investigate the possible relationships between immunomodulating medications, SARD type/flare, vaccine doses and novel viral variants with prolonged COVID-19 symptoms and other postacute sequelae of COVID-19 among people with SARDs.


Subject(s)
Arthritis, Rheumatoid , COVID-19 , Rheumatology , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Female , Humans , Male , Middle Aged , Surveys and Questionnaires
5.
Int J Infect Dis ; 111: 242-252, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34428547

ABSTRACT

OBJECTIVES: A retrospective study was undertaken to investigate the circulating dengue virus (DENV) serotypes and genotypes in India in 2018. METHODS: In total, 4963 samples referred to virus research diagnostic laboratories (n=21), the Indian Council of Medical Research-National Institute of Virology (ICMR-NIV) and ICMR-NIV field units (n=2) for diagnosis of dengue in 2018 were tested using a real-time reverse transcription polymerase chain reaction assay for the presence of DENV serotypes. Representative samples were sequenced for the envelope (E) gene. RESULTS: Regional diversity was observed with regard to the dominant circulating serotypes. DENV-2 was found to be the most common serotype in many states. Thrombocytopenia, petechiae and malaise were associated with DENV-2 infection. Phylogenetic analyses of DENV E gene sequences revealed the circulation of genotypes I and V of DENV-1, two lineages of DENV-2 genotype IV, DENV-3 genotype III and DENV-4 genotype I. CONCLUSIONS: This study found regional differences in the prevalence of circulating DENV serotypes in India, and provides baseline data for continuous molecular surveillance. Molecular surveillance may have implications for predicting large-scale outbreaks of dengue if regional shifts in the predominantly circulating serotypes and genotypes are detected during the early phase of the dengue season.


Subject(s)
Dengue Virus , Dengue , Dengue/diagnosis , Dengue/epidemiology , Dengue Virus/genetics , Genotype , Humans , India/epidemiology , Laboratories , Phylogeny , Retrospective Studies , Serogroup
6.
J Med Virol ; 92(8): 1013-1022, 2020 08.
Article in English | MEDLINE | ID: mdl-31769526

ABSTRACT

In 2017, Tamil Nadu, a southern state, had the second highest number of dengue cases from India. In the present study, the serotype-specific differences in the clinical manifestations and laboratory parameters among hospitalized children with dengue were investigated and molecular characterization of the circulating dengue virus (DENV) serotypes during 2017 in Tamil Nadu was performed. Eighty children with dengue-like symptoms consecutively admitted to a tertiary care hospital and positive for DENV NS1 antigen were investigated for DENV serotype utilizing a real-time reverse transcriptase based polymerase chain reaction assay. Complete envelope (E) gene sequencing of the DENV strains was performed. Seventy samples were positive for serotyping (25 DENV-1, 17 DENV-2, six DENV-3, and 22 DENV-4). DENV-4 infections were associated with elevated levels of liver enzymes; Alanine aminotransferase (P = .021) and aspartate aminotransferase (P = .001). However, none of the serotype was associated with any specific clinical features and severe dengue. Asian and American/African genotypes of DENV-1 were cocirculating. The circulating genotype was cosmopolitan for DENV-2 with multiple lineages, genotype III for DENV-3 and genotype I for DENV-4. Unique mutations were present in the 2017 DENV-4 isolates. The present study suggests the association of DENV-4 with elevated liver enzymes in children hospitalized for dengue. Further, the study reports the genetic diversity of DENV circulating in Tamil Nadu during 2017. The study calls for continuous monitoring of the circulating serotypes and genotypes at regional level in India which might result in a region wise database useful in predicting future outbreaks.


Subject(s)
Dengue Virus/classification , Dengue Virus/genetics , Dengue/virology , Genetic Variation , Adolescent , Alanine Transaminase/metabolism , Aspartate Aminotransferases/metabolism , Child , Child, Preschool , Cross-Sectional Studies , Dengue/blood , Dengue/epidemiology , Dengue Virus/isolation & purification , Female , Genotype , Hospitalization , Humans , India/epidemiology , Infant , Liver/enzymology , Male , Phylogeny , Prospective Studies , Serotyping , Severe Dengue/epidemiology , Severe Dengue/virology , Severity of Illness Index
7.
Infect Genet Evol ; 75: 103989, 2019 11.
Article in English | MEDLINE | ID: mdl-31376506

ABSTRACT

Dengue virus type 1 (DENV-1) Asian and American/African (AM/AF) genotypes were reported to be co-circulating in southern and western states of India based on envelope (E) gene sequencing of few representative samples. The objective of the present study was to develop a one-step real-time RT-PCR to discriminate between Asian and AM/AF genotypes of DENV-1 and investigate the spatio-temporal distribution of the DENV-1 genotypes in southern and western states of India. A one-step real-time RT-PCR to discriminate the Asian and AM/AF genotypes of DENV-1 was developed and validated using 40 samples (17 Asian and 23 AM/AF), for which the envelope (E) gene sequence data was available. DENV-2, DENV-3 and DENV-4 isolates, one each and DENV negative samples (n = 17) were also tested by the assay. Additional 296 samples positive for DENV-1 from selected Southern and Western states of India were genotyped using the real-time RT-PCR assay. Among the samples used for validation, the genotyping results were concordant with sequencing results for 39 samples. In the one discordant sample which was positive for AM/AF by sequencing, the genotyping assay tested positive for both Asian and AM/AF genotype. DENV-2, DENV-3 and DENV-4 isolates were not reactive in the assay. None of the DENV negative samples were positive (sensitivity 100% and specificity 98.2%). A total of 336 samples (40 samples with sequence data and 296 samples without sequence data) were used for spatio-temporal distribution analysis. The results revealed that the Asian genotype was the predominant genotype in Tamil Nadu and Kerala, the southern states. The AM/AF genotype was the predominant genotype in Maharashtra, a western state of India. In Nashik district of Maharashtra, Asian genotype was observed in 32.6% of DENV-1 samples during 2017 while the same decreased to 7.3% during 2018. In Pune district, Asian genotype was observed in 40.0% of DENV-1 samples during 2018 only. To conclude, a one step real-time RT-PCR has been developed for discriminating Asian and AM/AF genotypes of DENV-1. This assay can act as a complement to sequencing but not a substitute and can be utilized in resource limited settings for molecular surveillance of DENV-1. DENV-1 Asian genotype was the dominant genotype in South India while, AM/AF genotype was dominant in Western India.


Subject(s)
Dengue Virus/classification , Dengue/diagnosis , Reverse Transcriptase Polymerase Chain Reaction/methods , Viral Envelope Proteins/genetics , Asia , Dengue Virus/genetics , Genotype , Humans , India , Phylogeny , Sensitivity and Specificity , Sequence Analysis, RNA , Spatio-Temporal Analysis
8.
Infect Genet Evol ; 66: 272-283, 2018 12.
Article in English | MEDLINE | ID: mdl-30366083

ABSTRACT

India witnessed dengue outbreaks during 2017 in different parts with more than 180000 cases. There is no data on the serotypes/genotypes of dengue virus (DENV) associated with the 2017 outbreak season. The present study investigated DENV circulating in Pune and Nashik regions of Maharashtra, Western India at molecular level. IgM negative samples that were collected before 6th post onset days of illness were tested for DENV RNA and serotyped by real time RT-PCR based methods. Representative samples of each serotype were processed for virus isolation and envelope (E) gene sequencing. Among the 472 samples tested for DENV serotypes from Nashik, DENV-1 was observed in 36.2%, DENV-2 in 12.9%, DENV-3 in 35.4%, DENV-4 in 8.0%, and multiple serotypes in 7.4% of the samples respectively. In Pune region, among the 109 samples tested for DENV serotypes, DENV-1 was observed in 27.5%, DENV-2 in 11.0%, DENV-3 in 52.3%, DENV-4 in 4.6%, and multiple serotypes in 4.6% of the samples respectively. Comparison of serotype distribution from 2009 to 2017 from the Pune region revealed the emergence of DENV-3 as the dominant serotype followed by DENV-1 in 2017. In the Nashik region, both DENV-1 and DENV-3 were predominant in 2017. Phylogenetic analyses revealed co-circulation of American African (AM/AF) and Asian genotypes of DENV-1. DENV-1 Asian genotype was detected for the first time in the region. No genotype changes were observed for DENV-2 (cosmopolitan genotype), DENV-3 (genotype III) and DENV-4 (genotype I). For DENV-3, a unique amino acid substitution (I380T) was observed in the domain III of E protein of 2017 isolates and was not observed in earlier DENV-3 genotype III isolates. To conclude, the results suggest the emergence of DENV-1 with circulation of both Asian and AM/AF genotypes and DENV-3 with unique amino acid substitutions in Pune and Nashik regions. The study underscores the need for continuous molecular monitoring at a large scale to detect the changes in DENV serotypes/genotypes that might have implications for earlier prediction of dengue outbreaks and designing dengue vaccines and predicting its efficacy.


Subject(s)
Dengue Virus/classification , Dengue Virus/genetics , Dengue/epidemiology , Dengue/virology , Dengue/history , Dengue Virus/isolation & purification , Disease Outbreaks , Genotype , Geography, Medical , History, 21st Century , Humans , India/epidemiology , Molecular Epidemiology , Phylogeny , Phylogeography , Recombination, Genetic , Selection, Genetic , Serogroup , Viral Envelope Proteins/genetics
9.
J Colloid Interface Sci ; 470: 108-116, 2016 May 15.
Article in English | MEDLINE | ID: mdl-26939074

ABSTRACT

Exotic hierarchical rutile TiO2 nanostructures are synthesized by surfactant free single step hydrothermal route. The effect of reaction temperature, ranging from 140°C to 200°C on the properties of the synthesized rutile-TiO2 is investigated. The synthesized rutile-TiO2 nanostructures are characterized using X-ray diffraction, X-ray photoelectron spectroscopy, Raman spectroscopy, UV-vis spectroscopy and scanning electron microscopy techniques. The deposited TiO2 samples are found to be photoelectrochemically active and the best photoelectrochemical performance (0.95±0.05%) is obtained for the sample deposited at 180°C. A possible temperature dependent growth mechanism resulting in photochemically active TiO2 nanostructure thin films is proposed.

10.
Indian J Exp Biol ; 54(12): 801-7, 2016 12.
Article in English | MEDLINE | ID: mdl-30179427

ABSTRACT

Traditionally, the Indian Blackberry or locally called Jamun, Eugenia jambolana Lam. (Syn.: Syzygium cumini), is well known for its pharmacological potential, particularly anti-inflammatory. Here, we studied kaempferol-7-O-α-L-rhamnopyranoside]-4'-O-4'- [kaempferol-7-O-α-L-rhamnopyranoside (EJ-01) isolated from the E. jambolana leaves for possible anti-inflammatory activity. EJ-01 (3, 10 and 30 mg/kg, p.o.) was assessed for anti-inflammatory activity using carrageenan-induced paw edema model in mice by determining edema volume, myeloperoxidase (MPO), nitrite plus nitrate (NOx) and cytokine levels in paw edema tissue. EJ-01 significantly attenuated the edema, MPO levels, tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1ß) levels in the edema of paw at the 5th hour after carrageenan injection at all doses. EJ-01 (30 mg/kg) decreased the nitric oxide (NO) levels of the edema of paw at the 5th hour after carrageenan injection. The anti-inflammatory mechanisms of EJ-01 might be related to the decrease in the level of edema paw by reduced activities of NO and MPO. It probably exerts anti-inflammatory effects through the suppression of TNF-α and IL-1ß. Therefore, we conclude that EJ-01 could be positively exploited for itspotential benefits against inflammatory diseases and support the pharmacological basis of E. jambolana as traditional herbal medicine for the treatment of inflammatory diseases.


Subject(s)
Anti-Inflammatory Agents/pharmacology , Flavonoids/pharmacology , Plant Extracts/pharmacology , Plant Leaves , Syzygium/chemistry , Animals , Carrageenan , Edema , Mice , Tumor Necrosis Factor-alpha
11.
Compr Psychiatry ; 56: 59-68, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25459420

ABSTRACT

OBJECTIVE: Recently, the DSM-5 has developed a new diagnostic category named "Substance-related and Addictive Disorders". This category includes gambling disorder (GD) as the sole behavioral addiction, but does not include sex addiction (SA). The aim of this study is to investigate whether SA should be classified more closely to other behavioral addictions, via a comparison of the personality characteristics and comorbid psychopathology of individuals with SA with those of individuals with GD, which comes under the category of addiction and related disorders. METHOD: The sample included 59 patients diagnosed with SA, who were compared to 2190 individuals diagnosed with GD and to 93 healthy controls. Assessment measures included the Diagnostic Questionnaire for Pathological Gambling, the South Oaks Gambling Screen, the Symptom CheckList-90 Items-Revised and the Temperament and Character Inventory-Revised. RESULTS: No statistically significant differences were found between the two clinical groups, except for socio-economic status. Although statistically significant differences were found between both clinical groups and controls for all scales on the SCL-90, no differences were found between the two clinical groups. The results were different for personality characteristics: logistic regression models showed that sex addictive behavior was predicted by a higher education level and by lower scores for TCI-R novelty-seeking, harm avoidance, persistence and self-transcendence. Being employed and lower scores in cooperativeness also tended to predict the presence of sex addiction. CONCLUSIONS: While SA and GD share some psychopathological and personality traits that are not present in healthy controls, there are also some diagnostic-specific characteristics that differentiate between the two clinical groups. These findings may help to increase our knowledge of phenotypes existing in behavioral addictions.


Subject(s)
Behavior, Addictive/psychology , Gambling/psychology , Sexual Behavior , Adult , Cooperative Behavior , Diagnostic and Statistical Manual of Mental Disorders , Educational Status , Employment , Exploratory Behavior , Female , Harm Reduction , Humans , Male , Mental Disorders/complications , Middle Aged , Neuropsychological Tests , Personality , Socioeconomic Factors , Surveys and Questionnaires
12.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-672173

ABSTRACT

The interaction between fosfomycin (FOS) and bovine serum albumin (BSA) has been investigated effectively by multi-spectroscopic techniques under physiological pH 7.4. FOS quenched the intrinsic fluorescence of BSA via static quenching. The number of binding sites n and observed binding constant KA were measured by the fluorescence quenching method. The thermodynamic parameters △G0, △H0 and △S0 were calculated at different temperatures according to the van't Hoff equation. The site of binding of FOS in the protein was proposed to be Sudlow's site I based on displacement experiments using site markers viz. warfarin, ibuprofen and digitoxin. The distance r between the donor (BSA) and acceptor (FOS) molecules was obtained according to the F?rster theory. The effect of FOS on the conformation of BSA was analyzed using synchronous fluorescence spectra (SFS), circular dichroism (CD) and 3D fluorescence spectra. A molecular modeling study further confirmed the binding mode obtained by the experimental studies.

13.
J Eur Acad Dermatol Venereol ; 28(7): 949-56, 2014 Jul.
Article in English | MEDLINE | ID: mdl-23909847

ABSTRACT

BACKGROUND: The systematic support of parents of children with eczema is essential to their effective management; however, we have few models of support. This study examines the rationale, evidence base and development of a large-scale, structured, theory-based, nurse-led intervention, the 'Eczema Education Programme' (EEP), for parents of children with eczema. OBJECTIVES: To outline development of the EEP, model of delivery, determine its feasibility and evaluate this based on service access and parental satisfaction data. METHODS: Parent-child dyads meeting EEP referral criteria were recruited and demographic information recorded. A questionnaire survey of parental satisfaction was conducted 4 weeks post EEP; parental focus groups at 6 weeks provided comparative qualitative data. Descriptive statistics were derived from the questionnaire data using Predictive Analytics Software (PASW); content analysis was applied to focus group data. RESULTS: A total of 356 parents attended the EEP during the evaluation period. Service access was achieved for those in a challenging population. Both survey data (n = 146 parents, 57%) and focus group data (n = 21) revealed a significant level of parental satisfaction with the programme. CONCLUSIONS: It was feasible to provide the EEP as an adjunct to normal clinical care on a large scale, achieving a high level of patient/parent satisfaction and access within an urban area of multiple deprivation and high mobility. The intervention is transferable and the results are generalizable to other ethnically diverse child eczema populations within metropolitan areas in Britain. A multicentre RCT is required to test the effectiveness of this intervention on a larger scale.


Subject(s)
Eczema/psychology , Eczema/therapy , Models, Educational , Parents/education , Patient Education as Topic/trends , Adolescent , Adult , Child , Child, Preschool , Data Collection , Feasibility Studies , Female , Focus Groups , Humans , Infant , Male , Personal Satisfaction , Quality of Life/psychology , Surveys and Questionnaires , United Kingdom
14.
Br J Dermatol ; 169(3): 629-36, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23646904

ABSTRACT

BACKGROUND: The systematic support of parents of children with eczema is essential in effective disease management. The few existing support models have a limited evidence base. This paper reports the outcome-orientated service evaluation of an original, extensive, social learning-theory based, nurse-led Eczema Education Programme (EEP). OBJECTIVES: To evaluate the EEP using specified child and parental outcomes and service impact data. METHODS: From a sample of 257 parent-child dyads attending the EEP, a pretest-post-test design evaluated its child impact using health-related quality of life measures (Infants' Dermatitis Quality of Life index, which includes a small dermatitis severity element, and Children's Dermatology Life Quality Index), severity measures (Patient Orientated Eczema Measure), a new parental measure (Parental Self-Efficacy in Eczema Care Index) and service impact data based on general practitioner (GP) attendance patterns pre- and postintervention. RESULTS: Statistically significant impacts were observed on infant quality of life (P < 0·001), child quality of life (P = 0·027), disease severity (P < 0·001) and parental self-efficacy (P < 0·001). Improvements in child quality of life, parental efficacy and service impact were also evident from qualitative data. The cumulative total of all GP visits for selected participants post-EEP reduced by 62%. CONCLUSIONS: The EEP appears to be an effective model of delivering structured education to parents of children with eczema, and one generalizable to other multiethnic metropolitan populations. As a noncontrolled study, this rigorous service evaluation highlights the model's significance and the case for an evaluative multicentre randomized controlled trial of this educational intervention to inform a nurse-led programme of care.


Subject(s)
Eczema/therapy , Patient Education as Topic/methods , Adolescent , Child , Child, Preschool , Humans , Infant , London , Parents , Patient Acceptance of Health Care/statistics & numerical data , Quality of Life , Self Efficacy , Social Support , Treatment Outcome
15.
Eur J Pain ; 17(8): 1193-204, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23339021

ABSTRACT

BACKGROUND: Neuropathic pain is severely debilitating and resistant to pharmacological approaches; therefore, the study of therapies to complement its treatment is especially relevant. In a case report study, light-emitting diode therapy (LEDT) has shown analgesic activity as well as reduced the expression of pro-inflammatory cytokines in a rabbit osteoarthritis model and in calcaneal tendinitis in rats. Although LEDT stimulated morphofunctional recovery after nerve injury in rats, its effect against neuropathic pain has not been tested. METHODS: To that purpose, mice under anaesthesia were subjected to the sciatic nerve crush (SNC) model. On the seventh post-operative day, after determining analgesic dose (energy density in joules), LEDT (950 nm, 80 mW/cm2, 2.5 J/cm2 ) was irradiated, daily for a period of 15 days, on the skin over the crush site. RESULTS: Compared with the SNC group, LEDT reduced mechanical hypersensitivity but not cold hypersensitivity which is induced by SNC, decreased spinal cord and sciatic nerve levels of tumour necrosis factor alpha (TNF-α) but did not alter interleukin (IL)-1ß and IL-10 levels, and finally, failed to accelerate motor functional recovery and morphological nerve regeneration. CONCLUSION: Taken together, these data provide first-hand evidence of LEDT effectiveness against neuropathic pain induced by SNC, with corresponding decrease of pro-inflammatory cytokine levels, both in the sciatic nerve and in the spinal cord, although at a small analgesic dose, LEDT failed to accelerate nerve regeneration.


Subject(s)
Analgesics/therapeutic use , Lasers, Semiconductor/therapeutic use , Pain/drug therapy , Sciatic Nerve/injuries , Spinal Cord/metabolism , Tumor Necrosis Factor-alpha/metabolism , Animals , Disease Models, Animal , Male , Mice , Nerve Regeneration/physiology , Pain/metabolism , Pain/physiopathology , Pain Management/methods , Recovery of Function/physiology , Sciatic Nerve/physiopathology , Sciatic Nerve/surgery , Spinal Cord/physiopathology
16.
Neuroscience ; 193: 370-6, 2011 Oct 13.
Article in English | MEDLINE | ID: mdl-21835228

ABSTRACT

Manual acupuncture (MA) has presented analgesic activity against neuropathic pain in patients and animal models, yet a series of questions remain: Is MA effectiveness dependent of acupoint selection or combination? Is it equally efficient when treatment starts on the initial (acute) or sub-chronic phase of spinal nerve ligation (SNL)-induced neuropathy? Is MA effect related to the release of endogenous opioids? Does MA produce similar effects to gabapentin? To answer these questions rats submitted to the L5/L6 SNL injury were treated with unilateral MA (ST36 (Zusanli), SP6 (Sanyingjiao) or ST36+SP6 acupoint stimulation); or with gabapentin (30 mg/kg i.p., used as positive control). Both acupoints have been demonstrated to present analgesic activity and are used in clinical practice and basic science research. In addition, we investigated the influence of naloxone (1 mg/kg i.p., a nonselective opioid receptor antagonist) on MA treatment and also the effect of unilateral ST36+SP6 MA treatment beginning acutely (5 days) or sub-chronically (14 days) after SNL. Our results demonstrate that single or combined unilateral stimulation was able to reduce mechanical hypersensitivity with treatment beginning in both acute and sub-chronic phases of SNL-induced neuropathy; MA effect was blocked by naloxone, and finally; SP6+ST36 MA presented similar effect to gabapentin (30 mg/kg). In conclusion, our results demonstrate, for the first time, that unilateral MA (ST36, SP6 or ST36+SP6) reduces hypersensitivity induced by the SNL with effect dependent of the opioid system and comparable with the one obtained with gabapentin (used as positive control).


Subject(s)
Acupuncture Therapy/methods , Hyperalgesia/rehabilitation , Musculoskeletal Manipulations/methods , Pain Threshold/physiology , Spinal Nerves/physiopathology , Acupuncture Points , Amines , Analgesics/therapeutic use , Analysis of Variance , Animals , Cyclohexanecarboxylic Acids , Disease Models, Animal , Gabapentin , Hyperalgesia/drug therapy , Hyperalgesia/etiology , Ligation/methods , Male , Naloxone/pharmacology , Narcotic Antagonists/pharmacology , Neuralgia/complications , Neuralgia/drug therapy , Neuralgia/pathology , Pain Measurement , Pain Threshold/drug effects , Rats , Rats, Wistar , Time Factors , gamma-Aminobutyric Acid/drug effects
17.
J Assoc Physicians India ; 58: 568-9, 2010 Sep.
Article in English | MEDLINE | ID: mdl-21391377

ABSTRACT

An 18 years old mentally retarded male, with morphologic features suggestive of Down syndrome was admitted with fever since 3 weeks. Karyotyping proved trisomy 21. Prominent thyroid swelling with resting tachycardia and hyper-irritability was present. He was found to have multiple renal abscesses and was treated with antibiotics. Thyroid function tests revealed hyperthyroidism which responded to anti-thyroid drugs. So, we report this case of Down syndrome with hyperthyroidism which is a rare association.


Subject(s)
Carbimazole/therapeutic use , Down Syndrome/complications , Hyperthyroidism/complications , Propranolol/therapeutic use , Adolescent , Echocardiography , Humans , Hyperthyroidism/diagnosis , Hyperthyroidism/drug therapy , Male , Thyroid Function Tests , Thyroid Gland/diagnostic imaging , Treatment Outcome
19.
Micron ; 38(5): 500-4, 2007.
Article in English | MEDLINE | ID: mdl-17270449

ABSTRACT

Systematic improvement in interconnected web-like architecture with thickness of TiO2 films synthesized by spray pyrolysis method is reported and characterized for the structural, optical, surface morphological, and wettability properties. Deposited TiO2 films were crystalline with [120] direction orientation, uniform and adherent to the glass substrate. Interestingly, with increase in film thickness, fuzzy and blurred web-like architecture becomes more clear and sharp with well-defined boundaries. The band gap energy was decreased with increase in film thickness. Change in surface architecture resulted into smaller surface wettability in thick film compared to thin one.

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