The Chronological Evolution of Cochlear Implant Contraindications: A Comprehensive Review.

Cochlear implantation has emerged as a transformative intervention in addressing profound hearing loss, offering a paradigm shift in auditory rehabilitation for individuals with restricted auditory function. Throughout its history, the understanding of contraindications for cochlear implant (CI) surgery has evolved significantly. This review comprehensively analyzes the chronological advancements in the understanding of CI contraindications, examining studies conducted from historical timelines to the present. Recent research has revealed significant developments in the field, prompting a reevaluation of established criteria and resulting in expanded indications for CI. The chronological evolution of contraindications underscores the transformative nature of the field, offering potential improvements in outcomes and enhancing the quality of life for individuals with profound hearing loss. In conclusion, this narrative review emphasizes the dynamic nature of the field, where the reevaluation of contraindications has created new opportunities and broader indications for CI. The emerging prospects, including improved outcomes and enhanced quality of life, hold promise for individuals with profound hearing loss.

Assessing the Reliability of Miller's Classification and Cairo's Classification in Classifying Gingival Recession Defects: A Comparison Study.

Background and Objectives: Gingival recession results in adverse aesthetics and root sensitivity, and there is a need to treat and prevent its further progression. To overcome these problems, various advances have been made by clinicians in treating gingival recession based on the type of gingival recession. Miller's classification has been used for a long time to classify the type of recession. However, certain limitations have been found with use of Miller's classification such as a lack of clarity in the method for measuring soft and hard tissue loss in the interproximal area. Cairo classification was proposed to overcome limitations of Miller's classification to classify gingival recession. Cairo's classification is a treatment-oriented classification based on buccal and interproximal attachment loss. Therefore, the study was conducted to assess and compare the reliability of Miller's and Cairo's classifications in determining gingival recession. Material and methods: A total of 220 buccal gingival recession defects were included in the study based on the inclusion and exclusion criteria. Four examiners were included in the study. Two examiners classified the recession defects according to Miller's classification and the other two examiners classified recession defects according to Cairo's classification at baseline and at a 1-week interval. Statistical analysis was conducted using SPSS software version 25.0 using Cohen's kappa correlation coefficient and Chi-square test statistics to determine the intra- and inter-rater agreement among the examiners for the two gingival recession classification systems. A p value of <0.05 was considered statistically significant. Results: The intra-rater agreement for Cairo's classification was 0.86 and 0.82, whereas for Miller's classification, it was found to be 0.68. The inter-rater reliability agreement for Cairo's classification was 0.82 and 0.8, whereas for the Miller's classification, it was 0.56 and 0.67. Conclusions: Within the limitations of the study, it was found that Cairo's classification is clearer and more reliable than Miller's classification in the assessment of gingival recession.

Assessment of the in-vitro probiotic efficacy and safety of Pediococcus pentosaceus L1 and Streptococcus thermophilus L3 isolated from Laban, a popular fermented milk product.

Probiotics are beneficial microorganisms, mostly lactic acid bacteria (LAB), that offer health benefits to the host when consumed in adequate amounts. This study assessed the probiotic efficacy and safety of LAB strains isolated from Laban, a traditional fermented milk product. Seven primarily selected Gram-positive, catalase-negative, non-spore-forming isolates were examined for their antimicrobial activity against the bacterial pathogens Bacillus cereus, Salmonella typhi, Staphylococcus aureus, and Vibrio cholera, and the fungal pathogen Candida albicans. Two isolates, identified as Pediococcus pentosaceus L1 and Streptococcus thermophilus L3, which showed antimicrobial activity against all pathogens, were further evaluated for their probiotic competence. The selected isolates demonstrated strong resistance to low pH, bile salts, and phenol, indicating their potential for gastric endurance. They also exhibited high cell surface hydrophobicity to various hydrocarbons, autoaggregation, and coaggregation properties, demonstrating strong adhesion abilities. In addition, both isolates showed strong antioxidant activity and were non-hemolytic. Although the isolates had some resistance to certain antibiotics, they were generally susceptible to commonly used antibiotics. The two LAB strains also exhibited promising technological properties, such as milk coagulation and exopolysaccharide production, indicating their potential to enhance the quality of dairy products. The results suggest that the LAB strains isolated from Laban have strong potential as probiotics, and due to their food origin, they are highly likely to exhibit maximal efficacy in food and pharmaceutical products for human consumption.

Monitoring of hourly carbon dioxide concentration under different land use types in arid ecosystem.

Air pollution is a major factor affecting human life and living quality in arid and semiarid regions. This study was conducted in the Al-Ahsa district in the Eastern part of Saudi Arabia to measure carbon dioxide (CO2) concentration over different land-use types. Initially, the study's land use/land cover (LULC) was classified using the spectral characteristics of Landsat-8 data. Then, sensors were placed in five sites of different LULC types to detect CO2, air temperature, and relative humidity. The Friedman test was used to compare CO2 concentration among the five sites. Five LULC types were identified over the study area: date palm, cropland, bare land, urban land, and water. The results indicated that CO2 concentration showed a maximum mean value of 577 ppm recorded from a site dominated by urban lands. During the peak time of human transportation, a maximum value of 659 ppm was detected. The CO2 concentration mean values detected for the other LULC types showed 535, 515, and 484 ppm for the bare land, cropland, and date palm, respectively. This study's sensors and procedures helped provide information over relatively small areas. However, modelling CO2 fluctuations with time for LULC changes might improve management and sustainability.

The role of Serum Interleukin-4 and Interleukin-6 in Helicobacter pylori-infected patients.

BACKGROUND: Helicobacter pylori (H. pylori) is a Gram-negative bacteria that colonizes the gastrointestinal mucosa and causes chronic inflammation. AIMS: There are several studies related to cytokines concentrations in H. pylori infection, but there is no study that clarifies the role of IL-4 and IL-6 together in H. pylori infection. SUBJECTS: and methods: A total of (65) individuals, (25) healthy controls and (40) patients with H. pylori infection which are submitted to the hepato-gastrointestinal unit of AL-Imamian Al-Kadhimiyain medical hospital city in Baghdad consulted and diagnosed by traditional ways. In addition, the diagnosis was confirmed by ELISA Helicobacter pylori IgG kit. IL-4 and IL-6 levels were also assessed by using ELISA kits, according to the manufactures procedures. RESULTS: Significant increase of IL-4 and IL-6 concentration in seropositive patients compared with seronegative controls. CONCLUSION: Our findings and previous researches indicate that the immune response of gastric mucosa to H. pylori varies among patients. It depends on the stage of infection, and increases the cytokines secretion in the chronic stage, which is expected because of increased immune cell infiltration at the site of infection.

Shaping ability of 2Shape and NeoNiTi rotary instruments in preparation of curved canals using micro-computed tomography.

BACKGROUND: Various systems of nickel-titanium (NiTi) instrument have long been commercially available. However, the preparation of narrow and curved root canals has always been challenging. The purpose of this study was to compare the shaping ability of two NiTi systems (2Shape and NeoNiTi) in severely curved root canals with different morphological patterns using micro-computed tomography (Micro-CT). METHODS: A total of 22 human extracted permanent teeth of mandibular first molars, with the exact mesial angle of curvature of 25 and 35 degrees, according to Schneider's technique, were distributed randomly into two groups (group I: 2Shape, group II: NeoNiTi) based on the rotary system used (n = 22). The groups were subdivided into two subgroups corresponding to the angle of canal curvature (25° and 35°) (n = 11). Canals were scanned using Micro-CT pre- and post-preparation to assess the volume of dentin removed; canal transportation; and canal centering ratio at 3, 6, and 9 mm from the apex. The Mann-Whitney U test was utilized to determine any significant differences between the two systems. The level of statistical significance was set at p < 0.05. RESULTS: There was no significant difference between the two groups in volume of dentin removed; canal transportation; and centering ability for 25° and 35° canal curvatures at 3, 6, and 9 mm from the apex (coronal, middle, and apical) thirds (p > 0.05). At the middle third, the NeoNiTi group demonstrated a statistically significant increase in volume of dentin removed for 35° canal curvatures compared to the 2Shape group. CONCLUSION: Within the limitation of our in vitro study, 2Shape and NeoNiTi systems with severely curved canals were confirmed to be relatively safe in preparation and to respect original canal anatomy. Nevertheless, NeoNiTi instruments produced more centered preparation and minimal canal deviation compared to the 2Shape system.

Implementation of an educational module on nosocomial infection control measures: a randomised hospital-based trial.

BACKGROUND: Previous cross-sectional studies have reported limited knowledge and practices among nurses regarding controlling nosocomial infections (NIs). Even though health institutions offer many irregular in-service training courses to solve such issues, a three year-nursing educational programme at institutions is not adequate to enable nurses to handle NIs. Therefore, this study aims to evaluate the implementation of an educational module on NIs control measures among Yemeni nurses. METHODS: A single-blinded randomised hospital-based trial was undertaken involving 540 nurses assigned to two intervention groups and a waitlist group. Intervention group-1 received a face-to-face training course comprising 20 h spread over six weeks and a hard copy of the module, while intervention group-2 only received the hard copy of the module "without training". In contrast, the waitlist group did not receive anything during the period of collecting data. A self-administered NI control measures-evaluation questionnaire was utilised in collecting the data from the participants; before the intervention, at six weeks and 3 months after the end of the intervention. The period of data collection was between 1st May and 30th October 2016. RESULTS: The results from collecting and analysing the data showed a statistically significant difference in the mean knowledge scores between the intervention groups that were detectable immediately post-intervention with a mean difference (MD) of 4.31 (P < 0.001) and 3 months after the end of the intervention (MD = 4.48, P < 0.001) as compared to the waitlist group. Similarly, the results showed a statistically significant difference in the mean practice scores between the intervention groups immediately post-intervention (MD = 2.74, P < 0.001) and 3 months after the intervention (MD = 2.46, P < 0.001) as compared to the waitlist group. Intervention-1 (face-to-face training + module) was more effective than intervention-2 (module only) in improving Yemeni nurses' knowledge and practices regarding NI control measures compared to the waitlist group. CONCLUSION: The findings of this study found that intervention-1 could be offered to nurses in the form of an in-service training course every six months. The NI course should also be included in nursing curricula, particularly for the three-year-nursing diploma in Yemen. TRIAL REGISTRATION: Nosocomial infection educational module for nurses ISRCTN19992640 , 20/6/2017. The study protocol was retrospectively registered.

Randomized community trial on nosocomial infection control educational module for nurses in public hospitals in Yemen: a study protocol.

BACKGROUND: Nosocomial infections remain a global health problem and they are considered as one of the leading causes of increased morbidity and mortality. In-service training courses related to infection control measures can help nurses to make informed and therapeutic decisions which could prevent or reduce the incidence of nosocomial infections. This study protocol is of a hospital-based trial to develop, implement and evaluate an educational module on nosocomial infection control among nurses in public hospitals in Yemen. This study is currently ongoing and at the analysis stage. METHODS: A three-arm single-blinded randomized community hospital-based trial was conducted to evaluate the effectiveness of a newly developed nosocomial infection control educational module among nurses in public hospitals in Yemen. To ensure effective delivery and acquisition of knowledge, the Situated Learning Theory was applied during the course of the intervention. A total of 540 Yemeni in-ward nurses, who had three years nursing diploma and at least a year of working experience in the selected public hospitals were recruited in this study. The hospitals were the unit of randomization whereby eight hospitals were assigned randomly to intervention and waitlist groups. Intervention group-1 (n = 180) received an educational module supported by audio-video CD and a training course for eight weeks. Intervention group-2 (n = 180) was given only the educational module with audio-video CD (without the training course). The waitlist group received no intervention during the period of data collection but they will be given the same training and learning materials after the completion of the study. DISCUSSION: This study contributes to the lack of a nosocomial infection control educational module for nurses in Yemen. It is hoped that the educational module will serve as an effective approach to increase the nurses' knowledge and improve their practices regarding nosocomial infection control measures and hence decrease the prevalence of nosocomial infections in the future. TRIAL REGISTRATION: ID: ISRCTN19992640, Date of registration: 20/6/2017. This study protocol was retrospectively registered.

Correction to: Randomized community trial on nosocomial infection control educational module for nurses in public hospitals in Yemen: a study protocol.

[This corrects the article DOI: 10.1186/s12912-019-0333-3.].

Adherence towards Different Vaccines of Childhood Immunization of Under Five Year Old Children

Introduction: Adherence towards childhood immunization (completeness and timeliness), with consideration of age-dependent-seroconversion, is the basis for children protection. Despite high global and national immunization coverage, vaccine preventable diseases’ are rising. This study aimed to determine adherence (completeness and timeliness) towards different vaccines of childhood immunization and associated factors among mothers of under five children. Methods: Cross-sectional study design was conducted at a health clinic in Seremban. Total of 320 mothers of under five children attending child health clinic selected via systematic random sampling. Data collection was via validated self-administered questionnaires and proforma, analysed using SPSS version 22. Associations between categorical variables determined by chi-square tests. Results: Consented respondents were 314; resulting in response rate of 98.1%. Adherence (completeness) was 98.09% but only 56.5% - 97.1% of respondents adhered in terms of timeliness. Types of transportation was significantly associated with adherence (completeness), p=0.041. Employment status was significantly associated with adherence (timeliness) towards BCG (p=0.008), Hepatitis B dose one (p=0.018) and dose two (p=0.040) vaccines. Education level was significantly associated with adherence (timeliness) towards DTaP/IPV/HiB dose four (p=0.019). Maternal age and usage of government clinic were significantly associated with adherence (timeliness) of MMR dose one, p=0.030 and p=0.017 respectively. Conclusion: Adherence (completeness) was high but varying adherence towards vaccine timeliness. Transportation types associated with completeness. Employment status associated with BCG, first and second doses of Hepatitis B vaccines’ timeliness. Education level associated with fourth dose of DTaP/IPV/HiB. Maternal age and usage of government clinic associated with timeliness of first dose MMR.

Fears related to pregnancy and childbirth among primigravidae who requested caesarean versus vaginal delivery in Iran.

Pregnancy- and childbirth-related fears are common psychological concerns and the primary reasons for requesting caesarean section (CS). We aimed to examine the content of maternal fear and the associated demographic factors in a sample of Iranian primigravidae. A randomly selected sample of primigravidae (n = 342) was recruited in four health care centres in Iran. Data were collected using a 30-item questionnaire. Principal components factor analysis was applied to identify the main factors of pregnancy- and childbirth-related fears. All primigravidae reported some degree of fear, 48.2 % presented severe fear, and 62.6 % requested a CS because of childbirth-related fear. Most of the employed primigravidae with higher education level, higher family income, and unplanned pregnancy requested CS. The items constructed to measure maternal fear were subjected to exploratory factor analysis. Six categories were identified, including 'process of labour and childbirth', 'life and well-being of the baby', 'competence and behaviour of maternity ward personnel', 'own capabilities and reactions', 'becoming a parent and family life after delivery' and 'general fear in pregnancy' that cumulatively explained 55.3 % of the variance. The most common factor was 'life and well-being of the baby'. Severe fear was found in 70.6 % of those who chose CS, while 10.9 % of those who chose vaginal delivery reported severe fear. The between-group differences for mean scores and levels of fear were statistically significant. Pregnancy- and childbirth-related fears were frequently experienced by all low-risk primigravidae. Better strategies to address women's psychological needs during pregnancy are necessary.

Prevalence of Job stress and its Associated Factors among Universiti Putra Malaysia Staff

Introduction: Stress in the work place is a global major risk factor to worker’s health, which triggers the workers to be poorly motivated and less productive. Objectives: The objective of the study was to determine the prevalence of job stress and its associated factors among Universiti Putra Malaysia staff. Methods: This is a cross sectional study involving 511 academic and non-academic staff of Universiti Putra Malaysia in Serdang. Probability proportionate to size was used for calculating the required sample size. Results: The overall prevalence of stress was 21.7% (21.0% among male and 23.0% among female). The variables found to be significantly associated with stress were: Job demand, coworker support, depression, anxiety, focus and venting of emotion and self-blame (p<0.05). The findings revealed that UPM staffs are exposed to a range of specific stressors such as work stressor: job demand, lack of social support such as co-worker support and supervisor support, psychological stressors such as depression and anxiety, coping such as focus and venting of emotion and self-blame. Work stressor such as job demand was the main predictor of stress (p value = 0.001). Conclusion: The overall prevalence of job stress was 21.7%. The predictors job stress were job demand, lack of support from co-worker and supervisor, depression, anxiety and use of avoidance focused coping.

Baseline adherence, socio-demographic, clinical, immunological, virological and anthropometric characteristics of 242 HIV positive patients on ART in Malaysia

Adherence to antiretroviral therapy (ART) prevents disease progression, and the emergence of resistant mutations. It also reduces morbidity, and the necessity for more frequent, complicated regimens which are also relatively more expensive. Minimum adherence levels of 95% are required for treatment success. Poor adherence to treatment remains a stumbling block to the success of treatment programs. This generates major concerns about possible resistance of the human immunodeficiency virus (HIV) to the currently available ARVs. This paper aims to describe baseline results from a cohort of 242 Malaysian patients receiving ART within the context of an intervention aimed to improve adherence and treatment outcomes among patients initiating ART. A single-blinded Randomized Controlled Clinical Trial was conducted between January and December, 2014 in Hospital Sungai Buloh. Data on socio-demographic factors, clinical symptoms and adherence behavior of respondents was collected using modified, pre-validated Adult AIDS Clinical Trials Group (AACTG) adherence questionnaires. Baseline CD4 count, viral load, weight, full blood count, blood pressure, Liver function and renal profile tests were also conducted and recorded. Data was analyzed using SPSS version 22 and R software. Patients consisted of 215 (89%) males and 27 (11%) females. 117 (48%) were Malays, 98 (40%) were Chinese, 22 (9%) were Indians while 5 (2%) were of other ethnic minorities. The mean age for the intervention group was 32.1 ± 8.7 years while the mean age for the control group was 34.7 ± 9.5 years. Mean baseline adherence was 80.1 ± 19.6 and 85.1 ± 15.8 for the intervention and control groups respectively. Overall mean baseline CD4 count of patients was 222.97 ± 143.7 cells/mm³ while overall mean viral load was 255237.85 ± 470618.9. Patients had a mean weight of 61.55 ± 11.0 kg and 61.47 ± 12.3 kg in the intervention and control groups, respectively. Males account for about 90% of those initiating ART in the HIV clinic, at a relatively low CD4 count, high viral load and sub-optimal medication adherence levels at baseline.