Effect of prosthetic management and its timing on otological and audiological outcomes in infants with cleft lip and palate: A clinical trial.

PURPOSE: To evaluate how prosthetic management affects the otological and audiological state of infants with cleft lip and palate by preventing or treating otitis media (OM). MATERIALS AND METHODS: Thirty infants with cleft lip and palate (L/P) were assigned to three equal groups according to the age of prosthetic intervention; Group I: immediately after birth, Group II: 2 months old, Group III: 5 months old. Assessment of middle ear function by tympanometry and hearing quality by auditory brainstem response (ABR) under natural sleep was conducted before and after prosthetic treatment every month till 10 months of age. Data from the study groups were compared. RESULTS: No statistically significant differences were found between Gp I and Gp II in the 2nd, 3rd, and 4th months for right and left ears (p > 0.05). In the 5th month, statistically significant differences between the three groups were found in tympanometry for right (p = 0.011) and left (p = 0.024) ears also, in ABR for right (p = 0.007) and left (p = 0.011) ears. Tympanometric readings starting from the 6th till the 10th month showed no statistically significant differences between the three groups (p >0.05). The final ABR outcomes of the 10th month indicated statistically significant differences between the three groups for both ears (p = 0.027). CONCLUSIONS: Early prosthetic care could delay the development of OM, so it could potentially improve the otological and audiological state in infants with cleft L/P. However, prosthetic treatment may not be able to completely prevent or eliminate middle ear disorders.

Effect of prosthetic management of congenital cleft lip and palate on the middle ear function of infants: A clinical trial.

STATEMENT OF PROBLEM: Infants with a cleft palate often experience middle ear disease, a condition of great significance, and early prosthetic management of these infants is essential. However, any correlation between prosthetic palatal obturation and middle ear function is unclear. PURPOSE: The purpose of this clinical trial was to assess whether prosthetic palatal obturation with a feeding appliance prevented or improved middle ear problems in infants with a cleft lip and palate. MATERIAL AND METHODS: Ten infants with congenital cleft lip and palate (20 ears) were referred to the Prosthodontics department immediately after birth. Assessment of the middle ear function by tympanometry as well as hearing quality by auditory brainstem response (ABR) was conducted before the prosthetic treatment (control readings). The middle ear function and hearing quality was followed up after the prosthetic treatment every month until surgical palatal closure (tenth month). The Friedman test was applied to compare data from the various study periods. When the results were significant, the Dunn post hoc test was conducted to compare the control first week readings with those of the later periods (α=.05 for all tests). RESULTS: The preprosthetic readings of tympanometry in the first week were 90% Type A and 10% Type B for both right and left ears. Readings starting from the first to the fifth month revealed no statistically significant differences compared with the first week readings (P>.05). However, tympanometry readings starting from the sixth month (20% Type A and 80% Type B) until the tenth month (90% Type B and 10% Type C) for both ears represented a statistically significant difference compared with the first week readings (P≤.05). The preprosthetic readings of ABR in the first week showed that 90% of ears had normal hearing status and 10% had mild hearing loss. Readings starting from the first until the fifth month revealed no statistically significant differences compared with the first week readings (P>.05). However, ABR readings starting from the sixth month (20% normal hearing, 70% mild hearing loss, and 10% moderate hearing loss) until the tenth month (0% normal hearing, 80% mild hearing loss, and 20% moderate hearing loss) for both ears revealed a statistically significant difference compared with the first week readings (P≤.05). CONCLUSIONS: Prosthetic palatal obturation with a feeding appliance plays a role in delaying rather than preventing the occurrence of otitis media with effusion in infants with a cleft lip and palate and could reduce the need for ventilation tubes.

Fluoridation and dental caries severity in young children treated under general anaesthesia: an analysis of treatment records in a 10-year case series.

OBJECTIVE: To compare the severity of dental caries in the primary dentitions of children under 7 years (who received comprehensive restorative treatment under general anaesthesia, GA) from an optimally fluoridated area (0.85 ppmF) and a low-fluoride area (approximately 0.1 ppmF). RESEARCH DESIGN: Consecutive clinical case series: clinical details (diagnoses and the treatments provided) were recorded for children who had received comprehensive dental care under GA between 2000 and 2009. Age, gender, ethnicity, socio-economic status and fluoridation status (determined from the residential address) were also recorded. RESULTS: Of the 1396 treated children, 55.7% came from fluoridated areas and 52.5% were male. On average, children from low-fluoride areas were 2.4 months younger and presented with more decayed deciduous teeth than those from fluoridated areas (4.9 and 3.9 teeth respectively; p<0.0001). For each tooth type, the mean number of carious teeth at presentation was greater among the children from low-fluoride areas. In the multivariate model, the number of deciduous teeth affected by caries was lower among older children, those residing in a fluoridated area and among those seen after 2001. It was higher among those not living in high-SES areas. CONCLUSIONS: Children with severe dental caries had statistically significantly lower numbers of lesions if they lived in a fluoridated area. The lower treatment need in such high-risk children has important implications for publicly-funded dental care.

Biological changes after liver transplantation according to the presence or not of graft steatosis.

AIM: To assess the consequences of graft steatosis on postoperative liver function as compared with normal liver grafts. PATIENTS AND METHODS: From January 2005 to December 2007, liver transplant patients were prospectively included, excluding those who experienced arterial or biliary complications or presented acute rejection. All patients had a surgical biopsy after reperfusion. Patients were compared according to the rate of macrovacuolar steatosis: namely above or below 20%. RESULTS: Fifty-three patients were included: 10 in the steatosis group and 43 in the control group. No significant difference was observed in terms of morbidity, mortality, and primary non- or poor function. Nevertheless, biological changes after the procedure were significantly different during the first postoperative week. Prothrombin time, serum bilirubin, and transaminases were significantly increased among the steatosis group compared with the control group (P < .05). CONCLUSION: This case-controlled study including a small number of patients, described postoperative biological changes among liver transplantations with steatosis in the graft.

Acylated phenolic glycosides from Solenostemma argel.

From the aerial parts of Solenostemma argel, four new acylated phenolic glycosides sinapyl alcohol 9-O-feruloyl-4-O-alpha-rhamnopyranosyl-(1-->2)-beta-glucopyranoside, solargin I (1), sinapyl alcohol 9-O-caffeoyl-4-O-alpha-rhamnopyranosyl-(1-->2)-beta-glucopyranoside, solargin II (2), sinapyl alcohol 9-O-feruloyl-4-O-alpha-rhamnopyranosyl-(1-->2)-alpha-rhamnopyranosyl-(1-->2)-beta-glucopyranoside, solargin III (3) and sinapyl alcohol 9-O-caffeoyl-4-O-alpha-rhamnopyranosyl-(1-->2)-alpha-rhamnopyranosyl-(1-->2)-beta-glucopyranoside, solargin IV (4) have been isolated. The structures of the isolated compounds were verified by means of MS and NMR spectral analyses.

Near infra-red reflectance spectroscopic determination of metformin in tablets.

A rapid and simple near infra red reflectance spectroscopic method was described for determination of anti-diabetic tablets. Partial least squares method was applied to the Savitsky-Golay smoothed first derivative spectral data revealed over wavelength range 1000-2500 nm from 11 different pulverized tablet batches in 2-mm quartz cell. The results were agreed well with those obtained by the official British Pharmacopoiea 1998 UV assay of metformin.

Monoterpene glucosides from Origanum syriacum.

From the aerial parts of Origanum syriacum, three new monoterpene glucosides thymoquinol 2,5-O-beta-diglucopyranoside (3), carvacrol 2-O-beta-glucopyranosyl-(1-->2)-beta-glucopyranoside (4) and p-menth-1-ene-3,4-diol 4-O-beta-glucopyranoside (5) together with two known monoterpene glucosides thymoquinol 2-O-beta-glucopyranoside (1), thymoquinol 5-O-beta-glucopyranoside (2) have been isolated. The structures of the isolated compounds were verified by means of MS and NMR spectral analyses.

Cardiac glycosides from Cryptostegia grandiflora.

From the leaves of Cryptostegia grandiflora, four new cardiac glycosides oleandrigenin 3-O-beta-glucopyranosyl-(1-->4)-beta-cymaropyranosyl-(1-->4)-beta-digitoxopyranoside, cryptostigmin I, oleandrigenin 3-O-beta-glucopyranosyl-(1-->4)-alpha-rhamnopyranoside, cryptostigmin II, 16-propionylgitoxigenin 3-O-beta-glucopyranosyl-(1-->4)-alpha-rhamnopyranoside, cryptostigmin III and oleandrigenin 3-O-beta-glucopyranosyl-(1-->6)-beta-glucopyranosyl-(1-->4)-beta-cymaropyranosyl-(1-->4)-beta-digitoxopyranoside, cryptostigmin IV have been isolated together with two known cardenolides subalpinosid and 16-O-acetyl-digitalinum verum. The structures of the isolated compounds were verified by means of MS and NMR spectral analyses.

Benzoxazinoid glucosides from Acanthus ilicifolius.

From the aerial parts of Acanthus ilicifolius, two benzoxazinoid glucosides, 7-chloro-(2R)-2-O-beta-D-glucopyranosyl-2H-1,4-benzoxazin-3(4H)-one and (2R)-2-O-beta-D-glucopyranosyl-5-hydroxy-2H-1,4-benzoxazin-3(4H)-one have been isolated, together with six known compounds. The structural elucidations were based on the analyses of spectroscopic data.

Acylated flavonoid glycosides from Bassia muricata.

From the arial parts of Bassia muricata, two acylated flavonoid glycosides quercetin-3-O-(6"-caffeoyl)-sophoroside and quercetin-3-O-(6"-feruloyl)-sophoroside have been isolated together with two known flavonoid glycosides quercetin-3-O-sophoroside and quercetin-3,7-O-beta-diglucopyranoside, as well as four known triterpenoidal saponins, oleanolic acid-3-O-beta-glucopyranoside, chikusetsusaponin IVa, chikusetsusaponin IVa methyl ester and oleanolic acid-3,28-beta-diglucopyranoside. The structures of the isolated compounds were verified by means of MS and NMR spectral analyses.

Lignan glucosides from Acanthus ilicifolius.

From the aerial part of Acanthus ilicifolius, two lignan glucosides, (+)-lyoniresinol 3a-[2-(3,5-dimethoxy-4-hydroxy)-benzoyl]-O-beta-glucopyranoside, and dihydroxymethyl-bis(3,5-dimethoxy-4-hydroxyphenyl) tetrahydrofuran-9(or 9')-O-beta-glucopyranoside have been isolated, together with eight known compounds. The structural elucidations were based on the analyses of physical and spectroscopic data.

Iridoid and megastigmane glycosides from Phlomis aurea.

From the leaves of Phlomis aurea, two new iridoids of unique structures named 3-epiphlomurin (1) and phlomurin (2), a new megastigmane glucoside phlomuroside (3) and a new benzyl alcohol glycoside having the structure benzyl alcohol-O-beta-xylopyranosyl-(1-->2)-beta-glucopyranoside (4) have been isolated together with four known iridoids auroside, lamiide, 8-epiloganin and ipolamiide, two known phenolic glycosides acteoside (verbascoside) and syringin, one known phenylethanoid glycoside 2-phenylethyl-O-beta-xylopyranosyl-(1-->2)-beta-glucopyranoside, one known lignan liriodendrin and three known flavonoids chrysoeriol-7-O-beta-glucopyranoside, acacetin-7-O-beta-glucopyranoside and luteolin-7-O-beta-glucopyranoside. The structures of the isolated compounds were verified by means of mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectral analyses.

Minor phenolics from Crinum bulbispermum bulbs.

From the bulbs of Crinum bulbispermum Milne, four new minor compounds were isolated viz. 4-hydroxy-2',4'-dimethoxydihydrochalcone (1), 4,5-methylenedioxy-4'-hydroxy-2-aldehyde[1,1'-biphenyl] (4), hippacine (6), and 4'-hydroxy-7-methoxyflavan-3-ol (7). In addition, four known compounds were isolated and identified as 2(S),3',4'-dihydroxy-7-methoxy flavan (2), isolarrien (3), isoliquiritigenin (5) and liquiritigenin (8). The structures of the isolated compounds were established by spectral evidence.

Triterpenoidal saponins from Cornulaca monacantha.

From the aerial parts of Cornulaca monacantha, three new triterpenoidal saponins have been isolated and their genuine structures were identified as 3-O-[beta-xylopyranosyl-(1-->3)-beta- glucuronopyranosyl]-30-methylphytolaccagenate (2), 3-O-[beta-xylopyranosyl- (1-->3)-beta-glucuronopyranosyl]-30-methylphytolaccagenate 28-O-beta-gluco-pyranoside (3) and 3-O-[beta-xylopyranosyl-(1-->3)-beta- glucurono-pyranosyl]-30-methylserjanate 28-O-beta glucopyranoside (4) together with nine known saponins of oleanolic acid (5-9), hederagenin (1, 10, 11) and 30-methyl phytolaccagenate (12).

Monoterpene and pregnane glucosides from Solenostemma argel.

From the aerial parts of Solenostemma argel, two monoterpene glucosides have been isolated and identified as 6,7-dihydroxy-dihydrolinalool 3-O-beta-glucopyranoside and 6,7-dihydroxy-dihydrolinalool 7-O-beta-glucopyranoside. A pregnane glucoside was also isolated and assigned as pregn-5-ene-3,14-beta-dihydroxy-7,20-dione 3-O-beta-glucopyranoside together with the known compounds benzyl alcohol O-beta-apiofuranosyl-(1-->6)-beta-glucopyranoside, 2-phenylethyl O-alpha-arabinopyranosyl-(1-->6)-beta-glucopyranoside, astragalin and kaempferol-3-O-alpha-rhamnopyranosyl-(1-->2)-beta-glucopyranoside.

Studies on Securigera securidacea (L.) Deg. et Dörfl. (Fabaceae) seeds, an antidiabetic Egyptian folk medicine.

A new cardenolide(-)-14-methoxy-rcanoside (1) was isolated from the aqueous extract of the seeds of Securigera securidacea (L.) Deg. et Dörfl. (Fabaceae) together with five new dihydrobenzofuran derivatives named securigran I-V (2-6). Kaempferol and astragalin were also isolated from the aqueous extract of the flowers. (-)-14-Methoxyhyrcanoside and the total aqueous extract of the seeds showed marked chronotropic activity. The total aqueous extract also showed a marked diuretic and severe hypokalemic effects on the K(+)-level in serum. The hypoglycemic effect of the seeds was also confirmed.

A furostanol saponin from fruits of Balanites aegyptiaca.

A new furostanol saponin was isolated from the mesocarp of Balanites aegyptiaca fruits and identified as 26-O-beta-D-glucopyranosyl-(25R)-furost-5-ene-3,22,26-triol 3-O-[[alpha-L-rhamnopyranosyl-(1-->2)]-[beta-D-xylopyranosyl-(1-->2)]-be ta- D-xylopyranosyl-(1-->2)]-beta-D-xylopyranoside (balanitesin).

Pregnane glycosides from fruits of Balanites aegyptiaca.

From the mesocarp of Balanites aegyptiaca fruits, two pregnane glycosides were isolated. One is new and identified as pregn-5-ene-3 beta,16 beta,20(R)-triol 3-O-(2,6-di-O-alpha-L-rhamnopyranosyl)-beta-D-glucopyranoside (balagyptin), while the other is known and assigned as pregn-5-ene-3 beta,16 beta,20(R)-triol 3-O-beta-D-glucopyranoside.

Studies on Balanites aegyptiaca fruits, an antidiabetic Egyptian folk medicine.

An aqueous extract of mesocarps of the fruits of Balanites aegyptiaca exhibited a prominent antidiabetic activity by oral administration in streptozotocin induced diabetic mice. From one of the active fractions of this extract, two new steroidal saponins were isolated, and their structures were determined as 26-O-beta-D-glucopyranosyl-(25R)-furost-5-ene-3 beta,22,26-triol 3-O-[alpha-L-rhamnopyranosyl-(1----2)]-[beta-D-xylopyranosyl-(1---- 3)]-[alpha-L-rhamnopyranosyl-(1----4)]-beta-D-glucopyranoside and its 22-methyl ether. In addition, two known saponins, 26-O-beta-D-glucopyranosyl-(25R)-furost-5-ene-3 beta,22,26-triol 3-O-(2,4-di-O-alpha-L-rhamnopyranosyl)-beta-D-glucopyranoside and its methyl ether were isolated and identified. It was revealed that the individual saponins did not show antidiabetic activity, while the recombination of these saponins resulted in significant activity. From an ethanolic extract of the epicarps, two known flavonol glycosides, isorhamnetin-3-O-robinobioside and isorhamnetin-3-O-rutinoside were isolated and identified.

Effectiveness of the nitroblue tetrazolium test in demonstrating reduced bactericidal activity of polymorphonuclear neutrophils in schistosomal hepatosplenomegaly and ascites.

The nitroblue tetrazolium (NBT) test was carried out on blood from ten normal individuals and 20 schistosomal patients, ten of whom had hepatosplenomegaly and ten hepatosplenomegaly and ascites. The test revealed defective neutrophils in patients who had hepatosplenomegaly accompained by ascites. The phagocytic and bactericidal effects from five of each of the two groups of patients; results substantiated tose obtained by the NBT screening test. The NBT screening test thus proved useful in detecting acquired defective function of neutrophils in a helminthic parasitic disease that is accompanied by frequent bacterial infections.