Synthesis and analyses of injectable fluoridated-bioactive glass hydrogel for dental root canal sealing.

This study aimed to synthesize fluoride-doped bioactive glass (F-BG) based thermo-sensitive injectable hydrogel for endodontic applications. The structural and phase analyses were done with Fourier Transform Infrared spectroscopy and X-ray Diffraction, respectively. The setting time of prepared injectable was investigated at 21°C (in the presence and absence of an ultrasonic scalar) and at 37°C. Flowability was tested according to ISO-6876:2012 specifications, whereas injectability was checked by extrusion method using 21-, 22-, and 23-gauge needles. The in vitro bio-adhesion and push-out bond strength were studied on days 7 and 90 and compared with the commercially available TotalFill®. The ion release profile was analyzed for up to 30 days with Inductively Coupled Plasma Optical Emission Spectroscopy. The fluoride release analysis was conducted periodically for up to 21 days in deionized water and artificial saliva using an ion-selective electrode. The final setting time at 21°C, 21°C+ultrasonic scalar, and 37°C were 38.66±3.21, 29.12±1.23, and 32±3.46 min, respectively. The flowability was 25±3.94 mm, and the injectability coefficient was ≥70.3 for 22, 21, and 57% in a 23-gauge needle. Fluoride release in deionized water was found to be significantly higher than in artificial saliva and increased with time. A significant difference in bond strength was found between days 7 and 90, where the strength was increased, and a new apatite layer was formed on the tooth surface. A rapid release of calcium, phosphate, and silicon ions was seen initially, whereby the continuous release of these ions was observed for up to 30 days. The prepared F-BG injectable hydrogel has shown promising results and has the potential to be used as an endodontic sealer.

Surface Microhardness Of Microhybrid And Nanocomposite After Storage In Mouth Washes.

BACKGROUND: Dental composites are aesthetic direct restorative material. However, the effect of mouthwashes on the durability of the material is controversial. This study evaluated and compared the influence of mouthwash composition on the surface hardness of nanofilled (Z350XT) and microhybrid (P60) resin composites. METHODS: Comparative in-vitro study was conducted over 6 months at Multan Medical & Dental College. Sixty-four disc-shape specimens of each {nanofilled (Z350XT) and microhybrid (P60)} resin composite were prepared and stored in distilled water at 37°C for 24 hours. The baseline microhardness reading (To) was recorded by Vickers micro-hardness tester. Samples were then randomly divided into four groups (n=16) and stored in Listerine Cool Mint, Colgate Plax, Clinica and distilled water (control). The hardness test was repeated after 12 hours and 24 hours of storage. RESULTS: Nanocomposite (Z350XT) had statistically (p<0.01) higher surface hardness. A significant reduction (p≤0.05) in microhardness was observed after immersion of samples in mouthwashes. The reduction in surface hardness was dependent on the immersion time and composition of mouthwashes. Listerine Cool Mint (alcohol-based mouthwash) had greatest degradation effect. CONCLUSIONS: Mouth rinses negatively impacted the surface microhardness of the tested resin-based materials. Alcohol-based mouthwashes had greater potential for reducing microhardness. Microhybrid composite appears to be a more suitable material for restoring teeth in patients accustomed to using regular mouthwashes.

Spectrum of High Resolution Computed tomography chest findings in PCR positive COVID-19 patients according to duration of infection and CT severity score assessment.

OBJECTIVE: To evaluate the spectrum of HRCT findings of COVID-19 in RT-PCR positive patients according to duration of infection and severity of disease. METHODS: This retrospective study was conducted at Radiology department of Lahore General Hospital, Lahore from May to July 2020. Total 40 COVID-19 patients were reviewed for clinical features, HRCT chest findings based on time from symptom onset and CT conduction. Chi-square and fissure exact test were used for measuring association with severity of COVID-19, p value ≤0.05 was reported significant. Mean CT scores were calculated. ROC curve analysis showed threshold values of CT-SS for severe disease. RESULTS: Of total 40 patients with age ranged from 22-83 years, 22(55%) were males and 18(45%) females. The hallmark of COVID-19 was combined GGO and consolidation, GGO alone and consolidation alone in bilateral, sub pleural and posterior distribution. Early stage had normal CT or GGO alone, intermediate and late stage had both GGO and consolidation. Septal lines/bands and crazy paving pattern were prevalent in late stage. Clinically, 24 (60%) were in severe group and 16(40%) in mild group. Severity of COVID-19 was associated with GGO alone (p=0.05), GGO and consolidation (p=0.01), crazy paving (p=0.01) and lung scores (p≤0.05). The threshold values of CT-SS for identifying severe disease by two radiologists were 18.50 and 20.50. CONCLUSION: HRCT manifestations along with CT-SS aids in predicting disease severity. Staging according to duration of infection is effective in understanding variation in pattern of chest findings in coronavirus disease.

Comparison of HRCT Chest and RT-PCR in Diagnosis of COVID-19.

OBJECTIVE: To compare the diagnostic accuracies of HRCT chest and RT-PCR results in diagnosis of coronavirus disease (COVID-19) in a tertiary care hospital in Lahore. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Radiology and Central Research Lab, Lahore General Hospital, Lahore, from April to July, 2020. METHODOLOGY: Patients aged 18 to 83 years, who had clinically suspected symptoms of COVID-19 (fever, cough/sore throat or shortness of breath) presenting in outpatient or emergency department, were included. These patients had their HRCT chest conducted from Radiology Department and RT-PCR performed at Central Research Lab. These data were retrieved from electronic system of PACS. Results were categorised into positive and negative findings for COVID-19. Diagnostic accuracies of HRCT chest and first RT-PCR along with 95% confidence interval were calculated. RESULTS: A total of 94 patients, 55 (58.5%) males and 39 (41.5%) were females. Out of them, 83% patients had positive HRCT chest findings of COVID-19, 17% had negative HRCT chest findings; while 40.4% had positive and 59.6% had negative first PCR. Among the repeat second PCR, 19.6% had negative, 1.8% had positive PCR results; while 78.6% patients didn't undergo repeat PCR. The sensitivity, specificity, NPV, PPV and accuracy of HRCT chest was 92%, 23%, 81%, 45%, and 51%; while of first RT-PCR was 45%, 81%, 23%, 92% and 51%, respectively. CONCLUSION: The sensitivity of HRCT chest is higher (92%) as compared to first RT-PCR (45%). Key Words: COVID-19, RT-PCR, HRCT chest, Sensitivity, Specificity.

Comparison of HRCT Chest and RT-PCR in Diagnosis of COVID-19.

OBJECTIVE: To compare the diagnostic accuracies of HRCT chest and RT-PCR results in diagnosis of coronavirus disease (COVID-19) in a tertiary care hospital in Lahore. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Radiology and Central Research Lab, Lahore General Hospital, Lahore, from April to July, 2020. METHODOLOGY: Patients aged 18 to 83 years, who had clinically suspected symptoms of COVID-19 (fever, cough/sore throat or shortness of breath) presenting in outpatient or emergency department, were included. These patients had their HRCT chest conducted from Radiology Department and RT-PCR performed at Central Research Lab. These data were retrieved from electronic system of PACS. Results were categorised into positive and negative findings for COVID-19. Diagnostic accuracies of HRCT chest and first RT-PCR along with 95% confidence interval were calculated. RESULTS: A total of 94 patients, 55 (58.5%) males and 39 (41.5%) were females. Out of them, 83% patients had positive HRCT chest findings of COVID-19, 17% had negative HRCT chest findings; while 40.4% had positive and 59.6% had negative first PCR. Among the repeat second PCR, 19.6% had negative, 1.8% had positive PCR results; while 78.6% patients didn't undergo repeat PCR. The sensitivity, specificity, NPV, PPV and accuracy of HRCT chest was 92%, 23%, 81%, 45%, and 51%; while of first RT-PCR was 45%, 81%, 23%, 92% and 51%, respectively. CONCLUSION: The sensitivity of HRCT chest is higher (92%) as compared to first RT-PCR (45%). Key Words: COVID-19, RT-PCR, HRCT chest, Sensitivity, Specificity.

Adult human metapneumonovirus (hMPV) pneumonia mimicking Legionnaire's disease.

In adults hospitalized with viral pneumonias the main differential diagnostic consideration is influenza pneumonia. The respiratory viruses causing viral influenza like illnesses (ILIs), e.g., RSV may closely resemble influenza. Rarely, extrapulmonary findings of some ILIs may resemble Legionnaire's disease (LD), e.g., adenovirus, human parainfluenza virus (HPIV-3). We present a most unusual case of human metapneumonovirus pneumonia (hMPV) with some characteristic extrapulmonary findings characteristic of LD, e.g., relative bradycardia, as well as mildly elevated serum transaminases and hyphosphatemia. We believe this is the first reported case of hMPV pneumonia in a hospitalized adult that had some features of LD.

Persistent Legionnaire's disease in an adult with hairy cell leukemia successfully treated with prolonged levofloxacin therapy.

Legionnaire's disease (LD) manifests most commonly as an atypical community acquired pneumonia (CAP) with systemic extrapulmonary manifestations. Disorders associated with impaired cell mediated immunity (CMI) are particularly predisposed to LD. Hairy cell leukemia (HCL) is a rare B-cell lymphoproliferative leukemia associated with decreased CMI. LD has only rarely been reported in HCL. We present a most interesting case of persistent LD in a elderly male with HCL who required prolonged antibiotic therapy.