The Impact of Nonsurgical Periodontal Therapy on Serum Levels of Dickkopf-Related Protein-1 in Smokers and Nonsmokers with Periodontitis: A Prospective Comparative Study.

Purpose: This study aimed to evaluate and compare Dickkopf-related protein-1 (DKK1) serum levels and periodontal clinical parameters of smokers and nonsmokers with periodontitis at baseline and after nonsurgical periodontal treatment. Patients and Methods: A prospective comparative study was conducted among 24 patients with periodontitis who were divided according to the smoking habits into two groups: nonsmokers (G1) and smokers (G2). All the participants were assessed clinically by recording the probing depth (PD), clinical attachment loss (CAL), plaque index (PI), and bleeding index (BI), and immunologically by measuring the DKK1 serum levels at baseline and six weeks after nonsurgical periodontal therapy. Results: The two groups showed a significant decrease in PI, BI, and CAL after periodontal therapy (p < 0.05), while PD was significantly reduced in G1 (p = 0.005). The PI mean value was significantly higher at the baseline in G2 versus G1 (p = 0.050), while PD, BI, and CAL values were not significantly different between the groups (p = 0.056, p = 0.241, and p = 0.381, respectively). For DKK1 serum levels, there was a statistically significant decrease after treatment compared to the baseline for both groups (G1: p < 0.001; G2: p < 0.001) but no significant difference before (p = 0.131) and six weeks after treatment (p = 0.334) between the two groups. Conclusion: Although nonsurgical periodontal treatment effectively improved periodontal clinical parameters and reduced DKK1 serum levels, there were no significant differences in the DKK1 serum levels among the smokers and nonsmokers with periodontitis.

Prevalence of SARS-CoV-2 Antibodies in Laboratory Healthcare Workers at Assiut University Hospital, Egypt.

Background: COVID-19 is an illness caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Laboratory healthcare workers (LHCWs) are at highest risk for COVID-19 infection due to direct exposure to COVID-19 patients and/or infected samples. Objectives: Our primary objective in this study was to evaluate SARS-CoV-2 Ab testing as a screening tool for detecting COVID-19 infection among asymptomatic LHCWs. Our secondary aims were to establish the relationship between exposure to COVID-19 infection and subsequent asymptomatic disease and working in different areas of the laboratory. Method: The detection of SARS-CoV-2 antibodies was done by different methods (rapid testing, electrochemiluminescence, and chemiluminescent microparticle immunoassay). The study included 199 asymptomatic LHCWs at Assiut University Hospital, Egypt, from different laboratory areas including molecular biology, microbiology, parasitology, and outpatient clinic laboratories in addition to LHCWs involved in automation, phlebotomy, rotating physicians, and those working in the sample receiving area. Results: The incidence of SARS-CoV-2 antibodies by rapid testing and immunoassay among asymptomatic LHCWs was 29.6% and 24.4%. Laboratory phlebotomists (55.6%) were most likely to be exposed to positive patients and samples, followed by those working in the sample receiving area (32%), LHCWs in the automation area (29.6%), rotating doctors (28.6%), and LHCWs in the diagnostic molecular biology laboratory (15.4%). The sensitivities of the rapid test and SARS-CoV-2 total antibody were 94.1% and 92%, whereas the specificities were 92.6% and 91%. Conclusion: Rapid serological testing is an effective screening method for the detection of SARS-CoV-2 infection among asymptomatic LHCWs and the identification of the groups of workers who have a significantly higher seroprevalence than the rest of the laboratory population.

Uterine artery Doppler indices: pulsatility index and resistance index as predictive tools for the incidence of heavy menstrual bleeding related to copper intrauterine contraceptive device.

OBJECTIVES: To assess the predictive value of the initial uterine artery Doppler indices, the pulsatility index (PI), and resistance index (RI) in the prediction of heavy menstrual bleeding before and after copper intrauterine contraceptive device (IUCD) insertion. METHODS: The current prospective clinical study included 100 women who intended to use a copper IUCD (Cu T-380A) and met the inclusion criteria. Uterine artery Doppler PI and RI indices were calculated before IUCD insertion and at three and six months after insertion. Based on the presence or absence of menorrhagia, all women were classified into two groups: non-bleeding (n=52) and extreme menstrual bleeding (n=48). Receiver operating curve analysis was used to determine the predictive value of uterine artery PI and RI in patients with menorrhagia relevant to IUCD. RESULTS: The PI and RI indices displayed a highly significant difference between the IUCD groups at three and six months after insertion (P<0.001). Uterine artery PI ≤2.02 (sensitivity of 95.8%, specificity of 100%, and area below the curve [AUC] of 0.97 at P-value<0.001) and RI ≤0.83 (sensitivity of 93.8%, specificity of 100%, and AUC of 0.949 at P-value<0.001) were correlated with significant menstrual bleeding following insertion of IUCD. CONCLUSION: The presented results confirmed our assumption that the initial studies of uterine artery Doppler can predict heavy-menstrual bleeding associated with IUCD and therefore, should be conducted in women pursuing reversible longacting contraception.

Surveillance Study of Acute Neurological Manifestations among 439 Egyptian Patients with COVID-19 in Assiut and Aswan University Hospitals.

BACKGROUND: COVID-19 can be accompanied by acute neurological complications of both central and peripheral nervous systems (CNS and PNS). In this study, we estimate the frequency of such complications among hospital inpatients with COVID-19 in Assiut and Aswan university hospitals. MATERIALS AND METHODS: We screened all patients with suspected COVID-19 admitted from 1 June to 10 August 2020 to the university hospitals of Assiut and Aswan in Upper Egypt. Clinical and laboratory tests, CT/MRI of the chest and brain, and neurophysiology study were performed for each patient if indicated. RESULTS: 439 patients had confirmed/probable COVID-19; neurological manifestations occurred in 222. Of these, 117 had acute neurological disease and the remainder had nonspecific neuropsychiatric symptoms such as headache, vertigo, and depression. The CNS was affected in 75 patients: 55 had stroke and the others had convulsions (5), encephalitis (6), hypoxic encephalopathy (4), cord myelopathy (2), relapse of multiple sclerosis (2), and meningoencephalitis (1). The PNS was affected in 42 patients: the majority had anosmia and ageusia (31) and the others had Guillain-Barré syndrome (4), peripheral neuropathy (3), myasthenia gravis (MG, 2), or myositis (2). Fever, respiratory symptoms, and headache were the most common general symptoms. Hypertension, diabetes mellitus, and ischemic heart disease were the most common comorbidities in patients with CNS affection. CONCLUSION: In COVID-19, both the CNS and PNS are affected. Stroke was the most common complication for CNS, and anosmia and/or ageusia were common for PNS diseases. However, there were 6 cases of encephalitis, 2 cases of spinal cord myelopathy, 2 cases of MG, and 2 cases of myositis.

Distribution of Cytokeratin 17 in the Parenchymal Elements of Rat's Submandibular Glands Subjected to Fractionated Radiotherapy.

OBJECTIVES: The aim of this research was to study the intensity of cytokeratin 17 (CK17) in the parenchymal elements of rat's submandibular salivary glands subjected to fractionated radiotherapy regimen that used for treatment of head and neck malignancy. MATERIALS AND METHODS: Twenty male albino rats were divided into two equal groups (normal and irradiated). The irradiated group received a radiation dose of 5 Grays daily for 5 days using therapeutic X-ray beam. Six months later, submandibular gland was dissected out and prepared for both histological and immunohistochemical studies. RESULTS: Submandibular gland of irradiated group showed two different types of histological alterations. The first alteration showed severe gland atrophy replaced by either fibrous or fatty tissues. In some sections, the gland exhibited proliferating activity in the form of profuse amounts of mitotic figures. Immunohistochemical examination of control glands displayed a mild cytoplasmic expression of CK17 of duct cells as well as serous acini. The staining pattern was either diffused or concentrated at the basal part of the cell with negative expression at its apical part. STATISTICAL ANALYSIS: Expression of CK17 in submandibular gland of irradiated group displayed a highly significant differences (P < 0.001) in both intercalated and striated ducts. Many serous acini displayed a highly significant differences (P < 0.001) whereas, mucous acini were negatively stained. CONCLUSIONS: The intensity and diffusion of CK17 expression in our results foretell the pathological effect of radiotherapy on the intermediate filaments of salivary gland parenchyma that interfered with production and/or secretion of saliva leading to xerostomia.

Evaluation of cardiac biomarkers in smokers and non-smokers with chronic periodontitis.

OBJECTIVES: The present study aimed to assess the levels of the cardiac biomarkers in smokers versus non-smokers chronic periodontitis (CP) patients and periodontally healthy subjects, also to correlate cardiac biomarkers level with the severity of CP. METHODS: Eighty selected individuals were divided into three groups: Smokers CP (28), non-smokers CP (32), and healthy control subjects (20). The CP evaluated clinically by plaque index (PI), bleeding index (BI), clinical attachment loss (CAL), and pocket depth (PD). Serum levels of cardiac biomarkers were assayed for the following: Aspartate transaminase (AST), alanine transaminase (ALT), troponin-I (Tr-I), creatinine kinase (CK), and lactate dehydrogenase (LDH). RESULTS: The statistical analysis of the investigated biomarkers showed that ALT and AST significantly increased in smokers versus non-smokers CP patients (P ≤ 0.05). In addition, the other biomarkers (Tr-I, CK, and LDH) showed a non-significant increase in smokers compared with non-smokers periodontitis patients (P ≥ 0.05). Furthermore, the mean values of all biomarkers, Tr-I, ALT, AST, LDH, and CK, expressed highly significant comparisons (P ≤ 0.01) in smokers and non-smokers CP patients against healthy subjects. CONCLUSION: The present study suggested that the cardiac biomarkers affected by CP and worse aggravated by the presence of smoking that could play a bidirectional effect on periodontitis and cardiovascular (CV) conditions. Further researches are needed to elucidate the efficacy of periodontal treatment and serum cardiac biomarkers in systemically healthy and diseased CV patients.

Effectiveness of Probiotic Lozenges in Periodontal Management of Chronic Periodontitis Patients: Clinical and Immunological Study.

OBJECTIVE: The main purpose of this article was to evaluate the effect of probiotics used as an adjunctive to scaling and root planing (SRP) on the periodontal parameters and matrix metalloproteinase-8 (MMP-8) levels in gingival crevicular fluid (GCF) of chronic periodontitis patients. MATERIALS AND METHODS: A total of 25 chronic periodontitis patients who completed the treatment course of 40 subjects, aged 25 to 58 years, participated in this study. They were categorized into two groups: the first group was treated by SRP while the second group was treated by SRP and probiotic lozenges twice a day for 30 days. All patients were evaluated clinically by measuring the plaque index, bleeding index (BI), pocket depth, clinical attachment loss, and immunologically by assaying GCF/MMP-8 at baseline and 30 days after periodontal management. RESULTS: There was a significant improvement in periodontal parameters after SRP treatment with and without probiotic lozenges in both groups. However, there was a significant decrease in the BI (p = 0.05) in SRP and probiotic lozenges group after 30 days compared with SRP alone. In addition, there was a significant decrease in GCF/MMP-8 levels after 30 days in patients managed by SRP only (p = 0.017) compared with the baseline in both groups, whereas a highly significant decrease in patients treated by SRP and probiotics (p = 0.001). CONCLUSION: The current study suggested that the probiotics might have a beneficial effect on clinical and immunological outcomes in the management of chronic periodontitis patients. Further research is needed on a large-scale population and for a long recall time to confirm the response to probiotics as an adjunctive to SRP.

Clinical Value of Presepsin in Comparison to hsCRP as a Monitoring and Early Prognostic Marker for Sepsis in Critically Ill Patients.

Sepsis carries a poor prognosis for critically ill patients, even withintensive management. We aimed to determined early predictors of sepsis-related in-hospital mortality and to monitor levels of presepsin and high sensitivity C reactive protein (hsCRP) during admission relative to the applied treatment and the development of complications.An observational study was conducted on 68 intensive care unit (ICU) patients with sepsis. Blood samples from each patient were collected at admission (day 0) for measuring presepsin, hsCRP, biochemical examination, complete blood picture and microbiological culture and at the third day (day 3) for measuring presepsin and hsCRP. Predictors of sepsis-related in-hospital mortality were assessed using regression analysis. Predictive abilities of presepsin and hsCRP were compared using the area under a receiver operating characteristic curve. The Kaplan⁻Meier method was used to estimate the overall survival rate.Results showed that the sepsis-related in-hospital mortality was 64.6%. The day 0 presepsin and SOFA scores were associated with this mortality. Presepsin levels were significantly higher at days 0 and 3 in non-survivors vs. survivors (p = 0.03 and p < 0.001 respectively) and it decreased over the three days in survivors. Presepsin had a higher prognostic accuracy than hsCRP at all the evaluated times. Overall, in comparison with hsCRP, presepsin was an early predictor of sepsis-related in-hospital mortality in ICU patients. Changes in presepsin concentrations over time may be useful for sepsis monitoring, which in turn could be useful for stratifying high-risk patients on ICU admission that benefit from intensive treatment.

Biological effects of distension media in bipolar versus monopolar resectoscopic myomectomy: a randomized trial.

AIM: To estimate the effect of 0.9% saline during bipolar resectoscopy and 1.5% glycine during monopolar resectoscopy on hemodynamic, biochemical and hematological parameters. MATERIAL & METHODS: A prospective randomized study in a tertiary care university hospital and comprising of 155 patients scheduled for hysteroscopic myomectomy. They were subjected to bipolar resectoscopic myomectomy utilizing 0.9% saline in group A, and monopolar resectoscopic myomectomy utilizing 1.5% glycine in group B. Perioperative measurements of hemodynamic, hematological, and biochemical changes in all cases were reported. Likewise, intrauterine pressure throughout the different procedures was recorded. MAIN OUTCOME MEASURES: intraoperative difference with regards to fluid volume and subsequent systemic changes specially osmolarity. RESULTS: A significant increase of central venous pressure, end diastolic volume, end diastolic index, stroke volume, stroke index, cardiac output, cardiac index, postoperative prothrombin time and postoperative partial thromboplastin time in both groups with positive correlations between the absorbed fluid volume and these measurements in both groups. Moreover, there was a significant decrease in systemic vascular resistance, postoperative hemoglobin concentration, postoperative hematocrit value ratio, postoperative platelet count and postoperative prothrombin concentration in both groups and there were negative correlations between the absorptive fluid volume and these measurements in both groups. There were significant decrease in serum sodium concentration and postoperative serum osmolarity in glycine group (B) with negative correlations between the absorptive fluid volume and both serum sodium concentration and serum osmolarity in glycine group (B). CONCLUSIONS: The use of bipolar resectoscope utilizing 0.9% saline as a distention media is not associated with hyponatremia or hyposmolarity unlike monopolar resectoscope utilizing 1.5% glycine distending media in cases with submucous myoma of considerable size.