Efficacy of Glass Ionomer Cement as Pit and Fissure Sealant in Permanent First Molars.

Background/Objectives Pit and fissure caries constitute a predominant portion, approximately 90% in permanent posterior teeth and 44% in primary teeth among children and adolescents. Among various preventive modalities, pit and fissure sealants play a pivotal role in safeguarding these vulnerable areas. Categorized by materials such as glass ionomer, composites, and polyacid-modified glass ionomers, these sealants offer effective protection. This study aims to evaluate the efficacy of glass ionomer-based pit and fissure sealants in terms of retention rate at 12-month post-procedure period in permanent first molars. Methodology This study was conducted at the Department of Operative Dentistry, Nishtar Institute of Dentistry, Multan, Pakistan. Fifty-six children, aged 7 to 12 years, presenting with pit and fissure caries in permanent first molar teeth were enrolled. Glass ionomer sealant was meticulously applied to the affected pits and fissures. The efficacy was assessed after 12 months based on predefined criteria. Results The age of participants ranged from 7 to 12 years, with a mean age of 9.24 ± 1.38 years. Among the 56 patients, 23 (41.2%) were male and 33 (58.8%) were female. Sealant retention was noted in 31 (55.35%) patients, while 25 (44.65%) experienced sealant loss. In the 7 to 9-year age group, 19 demonstrated complete sealant retention, whereas in the 10 to 12-year age group, 12 exhibited complete retention. Concerning gender distribution, 17 males and 14 females exhibited complete sealant retention. Conclusion Glass ionomer-based sealants demonstrate excellent properties for pit and fissure sealing owing to their low technique sensitivity, cost-effectiveness, and favorable retention rates. Therefore, they represent an optimal choice for this preventive dental procedure.

Prevalence and Association of Transfusion-Transmissible Infections with Age of Blood Donors: A Regional Transfusion Centre Study in Northern Pakistan.

OBJECTIVE: To evaluate the prevalence and association of Transfusion-Transmissible Infections (TTIs) with age of blood donors in a regional transfusion centre located in Northern Pakistan. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Armed Forces Institute of Transfusion, Rawalpindi, Pakistan, from January 2017 to December 2021. METHODOLOGY: All blood donors who qualified institutional blood donation criteria were initially screened for HBsAg, Anti-HCV Ab, HIV antigen-antibody combination and syphilis by an automated chemiluminescent microparticle immunoassay analyzer (Architect Plus i 2000 SR, Abbott Diagnostics, Abbott Park, IL). Initially, all seronegative donor blood samples were subjected to nucleic acid amplification test (NAAT). All TTI-positive donors were immediately informed and counselled to consult the medical physicians for further treatment. Descriptive statistics and significance of association were determined. RESULTS: The prevalence of TTIs among blood donors was calculated to be 3.33% among 308,767 donors. HCV (1.4%) was the most prevalent TTI followed by syphilis (0.9%), HBV (0.68%) and HIV (0.26%), respectively. TTIs were most prevalent in the 26 to 35-year-old group, accounting for 5,143 (50.0%) positive donors (p<0.05). CONCLUSION: The prevalence of TTIs among blood donors was found to be 3.33%. HCV was the most common TTI, followed by syphilis, HBV, and HIV. The 26 to 35 year-old group had a significantly high prevalence of TTIs. KEY WORDS: Transfusion-transmissible infections, Hepatitis B virus, Hepatitis C virus, Human immunodeficiency virus, Treponema pallidum, Syphilis, Automated chemiluminescent microparticle immunoassay analyzer, Nucleic acid amplification test.

Oxygen Reduction Reaction Activity in Non-Precious Single-Atom (M-N/C) Catalysts-Contribution of Metal and Carbon/Nitrogen Framework-Based Sites.

We examine the performance of a number of single-atom M-N/C electrocatalysts with a common structure in order to deconvolute the activity of the framework N/C support from the metal M-N4 sites in M-N/Cs. The formation of the N/C framework with coordinating nitrogen sites is performed using zinc as a templating agent. After the formation of the electrically conducting carbon-nitrogen metal-coordinating network, we (trans)metalate with different metals producing a range of different catalysts (Fe-N/C, Co-N/C, Ni-N/C, Sn-N/C, Sb-N/C, and Bi-N/C) without the formation of any metal particles. In these materials, the structure of the carbon/nitrogen framework remains unchanged-only the coordinated metal is substituted. We assess the performance of the subsequent catalysts in acid, near-neutral, and alkaline environments toward the oxygen reduction reaction (ORR) and ascribe and quantify the performance to a combination of metal site activity and activity of the carbon/nitrogen framework. The ORR activity of the carbon/nitrogen framework is about 1000-fold higher in alkaline than it is in acid, suggesting a change in mechanism. At 0.80 VRHE, only Fe and Co contribute ORR activity significantly beyond that provided by the carbon/nitrogen framework at all pH values studied. In acid and near-neutral pH values (pH 0.3 and 5.2, respectively), Fe shows a 30-fold improvement and Co shows a 5-fold improvement, whereas in alkaline pH (pH 13), both Fe and Co show a 7-fold improvement beyond the baseline framework activity. The site density of the single metal atom sites is estimated using the nitrite adsorption and stripping method. This method allows us to deconvolute the framework sites and metal-based active sites. The framework site density of catalysts is estimated as 7.8 × 1018 sites g-1. The metal M-N4 site densities in Fe-N/C and Co-N/C are 9.4 × 1018 sites-1 and 4.8 × 1018 sites g-1, respectively.

Association of gut microbiome dysbiosis with the progression of atrial fibrillation: A systematic review.

OBJECTIVE: Many clinical and preclinical studies have implicated an association between atrial fibrillation (AF) and its progression to imbalances in the gut microbiome composition. The gut microbiome is a diverse and complex ecosystem containing billions of microorganisms that produce biologically active metabolites influencing the host disease development. METHODS: For this review, a literature search was conducted using digital databases to systematically identify the studies reporting the association of gut microbiota with AF progression. RESULTS: In a total of 14 studies, 2479 patients were recruited for the final analysis. More than half (n = 8) of the studies reported alterations in alpha diversity in atrial fibrillation. As for the beta diversity, 10 studies showed significant alterations. Almost all studies that assessed gut microbiota alterations reported major taxa associated with atrial fibrillation. Most studies focused on short-chain fatty acids (SCFAs), whereas three studies evaluated TMAO levels in the blood, which is the breakdown product of dietary l-carnitine, choline, and lecithin. Moreover, an independent cohort study assessed the relationship between phenylacetylglutamine (PAGIn) and AF. CONCLUSION: Intestinal dysbiosis is a modifiable risk factor that might provide newer treatment strategies for AF prevention. Well-designed research and prospective randomized interventional studies are required to target the gut dysbiotic mechanisms and determine the gut dysbiotic-AF relationship.

How does non-interest income affect bank credit risk? Evidence before and during the COVID-19 pandemic.

This paper considers the COVID-19 pandemic's role and investigates the impact of non-interest income on bank credit risk. Specifically, it performs a comparative analysis between before and during the pandemic periods. The data of listed banks are extracted from the BankFocus for 14 Asian emerging markets. The regression results indicate the positive influence of non-interest income on bank credit risk. Interestingly, the magnitude of the impact is higher in the pre-pandemic period, and it significantly reduces during the pandemic period. This study provides implications for bank practitioners and regulators.

Respiratory sequelae of dengue fever.

Dengue viral illness is endemic in many tropical countries with temperate climates. The haematological and cardiovascular sequelae of dengue are well known; however, respiratory manifestations are still an area of active medical research. We conducted a literature search on PubMed, Medline CINAHIL, EMBASE and found 64 articles on respiratory sequelae of dengue. All relevant original articles and case reports were included and the relevant information regarding the respiratory manifestations of dengue was retrieved from the relevant eligible articles. Respiratory manifestations of dengue range from mild pleural effusion to acute respiratory distress syndrome. The former was the most common complication, seen in 5.1% of patients, followed by acute respiratory distress syndrome (ARDS) in 1.7%, pneumonia in 0.5%, respiratory distress in 0.3%, pulmonary hemorrhage in 0.1%, and haemothorax in 0.01%. Involvement of the respiratory system indicates severe disease and is difficult to manage. Therefore its early detection is important.

Cytogenetic Profile Of Acute Lymphoblastic Leukaemia Patients And Its Association With Induction Remission Status.

Background: Acute lymphoblastic leukaemia is characterized by the presence of more than or equal to 20% lymphoblast (early lymphoid precursors) in peripheral blood and/or in bone marrow. Lymphoblast can infiltrate different organs and clinically patients can present with fatigue, pallor, fever, bone pain, bleeding or bruises and lymphadenopathy. ALL is the most common type of malignancy in children. To determine the cytogenetic abnormalities in patients of Acute Lymphoblastic Leukaemia as a predictor of response to induction chemotherapy. It was a descriptive cross-sectional study. Methods: This study was conducted at the Armed Forces Institute of Pathology, Rawalpindi over a period of six months from June to November 2019. Bone marrow and peripheral blood samples of newly diagnosed 80 patients of all the age groups and either gender, who received one month treatment for ALL,were analyzed for cytogenetic study. Patients who were previously diagnosed with ALL, who presented with relapse and those who required induction treatment outside the trial hospital were excluded. UK ALL 2011 treatment protocol was adopted for patients up to 25 years old and for patients above 25years old UK ALL 2014 treatment protocol as induction chemotherapy was adopted. Evaluation for remission was carried out at the termination of initial induction chemotherapy on day 29 of treatment. Results: A total of 80 patients were enrolled in the study, comprising 36 (45%) females & 44 (55%) males. The median age of paediatric patients was 5years (<19 years) who were 56/80 (70%) in number whereas the median age of adults was 27 years (>19 years) who constituted 24/80 (30%) of the participants. Cytogenetic of 51 (63.75%) patients revealed hyperdiploidy (chromosome number 51-66) whereas 29(36.25%) of the participants had miscellaneous mutations [(Hypodiploidy, t (9; 22), t (1; 19) and t (12; 21)]. On immunophenotyping 51/80 (63.7%) of the leukemias were of B cell origin and 29 (36.25%) of T-cell origin. Conclusion: Patients with hyperdiploidy, t (12;21) ETV6/RUNX1 and t(1;19)TCF3/PBX1 had better prognosis and higher remission rate compared to those with the other mutations like t(9;22)Ph+ and hypodiploid which were associated with poor prognosis. Association of gender with remission was not statistically significant.

Clinico-Haematologic Parameters And Assessment Of Post-Induction Status In Acute Lymphoblastic Leukaemia.

BACKGROUND: Acute Leukaemia is a malignant disorder characterized by an abnormal proliferation of immature cells, called blasts. Classically, acute leukaemia is classified into acute myeloid leukaemia and acute lymphoblastic leukaemia depending on the lineage of the immature cells. Objective of the study was to evaluate the clinical presentations, analyze the haematologic parameters at time of diagnosis and assess the post-induction status in newly diagnosed ALL patients. This cross-sectional study was conducted in the Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi from June to November 2019. METHODS: A total of 55 newly diagnosed ALL patients were recruited including children, adults and elderly. Detailed medical history and physical findings were noted. Haematologic parameters were documented. Each patient was treated as per standard protocol and remission induction status was determined on day 29 of treatment. RESULTS: The median age of the study cohort of 55 newly diagnosed ALL patients was 8.5 years. Males were 37 (67.3%) and females were 18 (32.7%) with a male to female ratio of 2:1. Paediatric group included 31 (56.4%) patients. Nine (16.4%) patients were in the adult group and 15 (27.3%) in the elderly age group. The time from onset of symptoms to diagnosis of acute lymphoblastic leukaemia was 98.87±79.21 days. Fever was the most common symptom but body aches were common among paediatric group while pallor was the most common sign. Mean WBC was 29.1±27.9 x109/l, Hb was 8.1±2.9 g/dl and platelet count was 60±41.8 x109/l B-acute lymphoblastic leukaemia was more common than T-acute lymphoblastic leukaemia. A total of 52 patients were assessed on day 29 to evaluate for post-induction remission status. The remission rate of our cohort of patients was 82.7%. CONCLUSIONS: Most of the patients were in paediatric age group and remission rate was better in this age group compared to elderly population. B-ALL was associated with good response to induction chemotherapy while patients with BCR-ABL1 gene rearrangement did not respond well to treatment. Identification of prognostic features at diagnosis will further help our clinicians to predict outcomes of the disease.

Effect of COVID-19 on lipid profile parameters and its correlation with acute phase reactants: A single-center retrospective analysis.

Background and objective: The development and correlation of dyslipidemia is unknown in COVID-19. This investigation was performed to assess the pathological alterations in lipid profile and their association in COVID-19. Methods: This was a retrospective study performed on real-world patients to assess serum levels of LDL-C, HDL, TG, TC on COVID-19 patients (mild: 319; moderate: 391; critical: 357). Age- and gender-matched controls who had their lipid profiles in the same period were included as the control group. Results: LDL-C, HDL, TG, and TC levels were significantly lower in COVID-19 patients when compared with the control group (P < 0.001, 0.047, 0.045, <0.001, respectively). All parameters decreased gradually with COVID-19 disease severity (LDL-C: median (IQR), mild: 98 (91,134); moderate: 97 (81,113); critical: 68 (68,83); HDL: mild: 45 (37,50); moderate: 46 (41,50); critical: 40 (37,46); TG: mild: 186 (150,245); moderate: 156 (109,198); critical: 111 (98,154); TC: mild: 224 (212,238); moderate: 212 (203,213); critical: 154 (125,187)). Logistic regression demonstrated lipid profile as predictor of severity of COVID-19 disease. Conclusion: Hypolipidemia develops in increasing frequency with severe COVID-19 disease. It inversely correlates with levels of acute-phase reactants, indicating SARS-COV-2 as the causative agent for alteration in lipid and thyroid levels.

Association of ABO blood group with COVID-19 severity, acute phase reactants and mortality.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is the ongoing pandemic with multitude of manifestations and association of ABO blood group in South-East Asian population needs to be explored. METHODS: It was a retrospective study of patients with COVID-19. Blood group A, B, O, and AB were identified in every participant, irrespective of their RH type and allotted groups 1, 2,3, and 4, respectively. Correlation between blood group and lab parameters was presented as histogram distributed among the four groups. Multivariate regression and logistic regression were used for inferential statistics. RESULTS: The cohort included 1067 patients: 521 (48.8%) participants had blood group O as the prevalent blood type. Overall, 10.6% COVID-19-related mortality was observed at our center. Mortality was 13.9% in blood group A, 9.5% in group B, 10% in group C, and 10.2% in AB blood group (p = 0.412). IL-6 was elevated in blood group A (median [IQR]: 23.6 [17.5,43.8]), Procalcitonin in blood group B (median [IQR]: 0.54 [0.3,0.7]), D-dimers and CRP in group AB (median [IQR]: 21.5 [9,34]; 24 [9,49], respectively). Regarding severity of COVID-19 disease, no statistical difference was seen between the blood groups. Alteration of the acute phase reactants was not positively associated with any specific blood type. CONCLUSION: In conclusion, this investigation did not show significant association of blood groups with severity and of COVID-19 disease and COVID-19-associated mortality.

Development of a highly active FeNC catalyst with the preferential formation of atomic iron sites for oxygen reduction in alkaline and acidic electrolytes.

Nitrogen-doped porous carbons containing atomically dispersed iron are prime candidates for substituting platinum-based catalysts for oxygen reduction reaction (ORR) in fuel cells. These carbon catalysts are classically synthesizedviacomplicated routes involving multiple heat-treatment steps to form the desired Fe-Nx sites. We herein developed a highly active FeNC catalyst comprising of exclusive Fe-Nx sites by a simplified solid-state synthesis protocol involving only a single heat-treatment. Imidazole is pyrolyzed in the presence of an inorganic salt-melt resulting in highly porous carbon sheets decorated with abundant Fe-Nx centers, which yielded a high density of electrochemically accessible active sites (1.36 × 1019 sites g-1) as determined by the in situ nitrite stripping technique. The optimized catalyst delivered a remarkable ORR activity with a half-wave potential (E1/2) of 0.905 VRHE in alkaline electrolyte surpassing the benchmark Pt catalyst by 55 mV. In acidic electrolyte, an E1/2 of 0.760 VRHE is achieved at a low loading level (0.29 mg cm-2). In PEMFC tests, a current density of 2.3 mA cm-2 is achieved at 0.90 ViR-free under H2-O2 conditions, reflecting high kinetic activity of the optimized catalyst.

Reduced graphene oxide as a stable and high-capacity cathode material for Na-ion batteries.

We report the feasibility of using reduced graphene oxide (RGO) as a cost-effective and high performance cathode material for sodium-ion batteries (SIBs). Graphene oxide is synthesized by a modified Hummers' method and reduced using a solid-state microwave irradiation method. The RGO electrode delivers an exceptionally stable discharge capacity of 240 mAh g-1 with a stable long cycling up to 1000 cycles. A discharge capacity of 134 mAh g-1 is obtained at a high current density of 600 mA g-1, and the electrode recovers a capacity of 230 mAh g-1 when the current density is reset to 15 mA g-1 after deep cycling, thus demonstrating the excellent stability of the electrode with sodium de/intercalation. The successful use of the RGO electrode demonstrated in this study is expected to facilitate the emergence of low-cost and sustainable carbon-based materials for SIB cathode applications.

Paroxysmal nocturnal hemoglobinuria.

Paroxysmal Nocturnal Hemoglobinuria (PNH) literally means to have episodes of hemoglobin in the urine during the night. It is a Coomb's negative rare hemolytic disorder characterized by non-malignant clonal expansion of haemopoietic stem cells due to acquired genetic mutations. A 30 years old male patient presented with 5 years history of transfusion dependent anemia with intermittent episodes of passing dark colored urine in the morning. Blood complete picture showed decreased hemoglobin and reticulocytosis upto 30%. Coomb's test was negative with unconjugated hyperbilirubinemia and markedly raised serum LDH. Urine analysis showed marked hemosiderinuria and flow cytometry revealed 60% RBCs deficient for CD-59, confirming the diagnosis of paroxysmal nocturnal hemoglobinuria. The management of the patient depends on whether anemia is due to hemolysis or as consequence of impaired erythropoiesis. Corticosteroids at a dose of 0.25-1 mg/kg/day was selected as it is amongst the various treatment options in patients with predominant hemolysis.