The Efficacy of Low-level Laser Therapy on Pain caused by Placement of the First Orthodontic Archwire: A Clinical Study.

Aim: This study was conducted to clinically evaluate the effect of low-level laser therapy (LLLT) as a method of reducing pain reported by patients after placement of their first orthodontic archwires. Materials and methods: A sample of 10 patients with an age group of 12 to 26 years with moderate-to-severe anterior crowding was selected. Each patient was assigned to an experimental group (left quadrant with laser therapy) and a control group (right quadrant with no laser therapy). Low-level laser therapy was given immediately after the placement of initial archwire. All patients were instructed to fill up a survey form at home over the next 7 days. Results: The results revealed that the average onset of pain in the experimental group (16.10 hours) was significantly reduced when compared with the control group (3.10 hours). The most painful day was similar for both the groups. The pain ceased much sooner in the experimental group than in the control group. The intensity of pain was lesser in the experimental group when compared with the control group. Conclusion: Low-level laser therapy was an effective and noninvasive method for controlling pain in orthodontic patients after receiving their first archwires. The duration and intensity of pain reduced with the application of LLLT Clinical significance: Pain reduction during orthodontic procedures. Keywords: Low-level laser therapy, Nickel-titanium wires, Orthodontic pain.

The spectrum of autosomal dominant polycystic kidney disease in children and adolescents.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder. It is characterized by the development of renal cysts and kidney enlargement and ultimately leads to renal failure typically in the sixth decade of life. Although most patients are asymptomatic until well into adulthood, renal cysts develop much earlier, often in utero. Significant renal anatomic and cystic expansion typically occurs before clinical manifestations in children and young adults with AKPKD. The cyst burden detected by imaging represents the minority of cyst burden, and renal and cardiovascular abnormalities are the most common manifestations in children with ADPKD. Here we review the molecular pathogenesis of ADPKD, discuss the screening, diagnosis and clinical manifestations of this renal disorder in childhood and adolescents and review treatment options and potential therapies currently being tested.

Phytofabrication of biocompatible chitosan-based ZnO nanocomposite aided by Cissus quadrangularis extract enriched with antimicrobial and antioxidant potential.

A dynamic chitosan-based ZnO nanocomposite (NC) was fabricated via a cost-effective formulation and an eco-friendly procedure utilizing Cissus quadrangularis (CQ) plant extract. This study investigates the antimicrobial and antioxidant properties, together with the cytocompatibility aspects of chitosan-incorporated ZnO nanocomposite (CS-ZnO/CQE). The formation and structural morphology of the nanocomposites were examined using FTIR, UV-Vis, XRD, XPS, BET, TGA, SEM, and TEM techniques. The antibacterial test results demonstrated the greatest inhibitory zone diameter against S. aureus (19 ± 1.00 mm) and E. coli (17 ± 1.05 mm), assessed through agar well diffusion method. Also, the composite exhibited a DPPH inhibition rate of 78.7 ± 0.34 %, indicating its high effectiveness in neutralizing free radicals. In addition, the nanocomposite exhibited less toxicity towards human erythrocytes, HDF and HEK-293 cells as a result of the biocompatibility exhibited by CS, ZnO, and CQ plant extract. Likewise, it has exceptional cell migratory capacity and possesses biodegradability factors. These observations strongly suggest the potential of CS-ZnO/CQE as a cutting-edge antibacterial and antioxidant agent to be implemented in the medical sector.

Serum biomarkers of maternal morbidity and adverse outcome in severe pre-eclampsia.

OBJECTIVE: To evaluate the association of maternal serum biomarkers of myocardial damage, oxidative stress and angiogenic imbalance with maternal adverse outcomes in women with severe pre-eclampsia. METHODS: This was a prospective cohort study, where maternal serum biomarkers were evaluated in women admitted with severe pre-eclampsia to a tertiary care centre between March 2019 and February 2020. Serum markers included brain naturetic peptide (BNP), cardiac troponin-T (cTnT), cystatin-C (cys-C), soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), Total Anti-Oxidant status (TAO) and malondialdehyde (MAO). Main outcome measures were adverse maternal outcomes defined as eclampsia, pulmonary oedema, acute kidney injury, placental abruption and HELLP syndrome. RESULTS: Adverse maternal outcomes occurred in 93(37.2%, 95% CI: 31.2%-43.6%) of the 250 women with severe pre-eclampsia included in the study, including 21 with pulmonary oedema, 25 with acute kidney injury and 36 with eclampsia. BNP levels were higher among women who developed pulmonary oedema (55.4 pg/mL vs 42.0 pg/mL, p = 0.008). TAO levels were higher in women who developed eclampsia (4.6 mM, IQR 3.1-5.7, p < 0.001) and acute kidney injury (4.1 mM, IQR 3.2-6.3, p = 0.002) compared to those who did not develop any complications (2.93 mM, IQR 2.3-4.1). CONCLUSIONS: Even though the endothelial dysfunction and oxidative stress biomarkers were associated with development of preeclampsia, it may have limited utility in identifying women who might develop adverse outcomes.

Characterization and distribution of microplastics and plastic debris along Silver Beach, Southern India.

Microplastics are causing serious environmental threats worldwide. To evaluate the current state of microplastics pollution, 28 sediment samples were examined for microplastics and plastic debris contamination along Silver Beach, Southern India. Visual identification followed by FT-IR spectroscopy was used to estimate the overall distribution and characterization of plastic debris. The results reveal that white-colored (44%) and irregularly-shaped (82%) plastics are prevalent in the study area. Moreover, the dominant polymer in the study area is polyvinyl chloride (79%) followed by polyethylene (14%) and nylon (7%). Based on size fractions, mesoplastics are widely distributed in the beach sediments (65%), followed by microplastics (18%) and macroplastics (17%). The regional sources of plastic debris are tourism and fishing activities followed by storm water runoff through the Gadilam river and wave-induced deposition through high tides. Strict policy measures need to be implemented in recreational beaches like Silver beach to reduce plastic pollution.

Tuberculous lymphadenitis is associated with altered levels of circulating angiogenic factors.

BACKGROUND: Angiogenic factors are important in granuloma formation and serve as biomarkers in pulmonary tuberculosis (PTB). The relationship between these markers and tuberculous lymphadenitis (TBL) is not known. OBJECTIVE AND DESIGN: To examine the association of vascular endothelial growth factor (VEGF) and angiopoietin (Ang) family molecules in TBL, we measured systemic levels of VEGF-A, C, D, R1 (VEGF-receptor 1), R2, R3, Ang-1, Ang-2 and TIE2 (tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 2) levels in TBL, latent tuberculous infection (LTBI) and lymph node culture supernatants (VEGF-A, C and Ang-2) of the same TBL patients. RESULTS: Circulating levels of VEGF-A and VEGF-C were significantly diminished, whereas VEGF-R2, R3, Ang-2 and TIE2 levels were significantly increased, in TBL. Likewise, VEGF-A, C and Ang-2 levels were significantly increased in lymph node supernatants compared with plasma in individuals with TBL. Receiver operating characteristic curve analysis showed that VEGF-C and VEGF-R2 markers clearly distinguished TBL from LTBI. Following treatment, VEGF-C and Ang-1 levels were significantly altered. No association was observed between angiogenic factors and culture grade or lymph node size, except for VEGF-A. VEGF-A was also significantly decreased in multiple lymph nodes compared with single lymph nodes. CONCLUSIONS: Our data suggest that altered levels of circulating angiogenic factors in TBL might reflect underlying vasculo-endothelial dysfunction. Reversal of angiogenic markers after anti-tuberculosis treatment suggests that these angiogenic markers may serve as biomarkers of disease severity or response to treatment in TBL.

Ipomoea batatas (Convolvulaceae)-mediated synthesis of silver nanoparticles for controlling mosquito vectors of Aedes albopictus, Anopheles stephensi, and Culex quinquefasciatus (Diptera:Culicidae).

We proposed an effective and eco-friendly control of dengue, malaria, and filariasis-causing vectors. We tested Ipomoea batatas leaves-mediated silver nanoparticles (AgNPs) against first to fourth instar larvae and adults of Aedes albopictus, Anopheles stephensi, and Culex quinquefasciatus at different concentrations. The synthesized AgNPs showed broad spectrum of larvicidal and adulticidal effects after 48 h of exposure. The characterization of synthesized AgNPs was done using various spectral and microscopy analyses. The maximum efficacy was observed in synthesized AgNPs against the adult of Ae. albopictus with the LC50 and LC90 values were 10.069 and 15.657 µg/mL, respectively, followed by others.

Emotional incontinence--the other poststroke phenomenon.

Emotional incontinence is a disorder of emotional control following brain damage. It refers to the heightened tendency to cry or less commonly laugh, out of proportion to the underlying mood. Recognition of this phenomenon is often lacking as it is confused with other related sequelae of brain damage such as depression. This is a case report of an elderly female exhibiting poststroke emotional incontinence.

Modulation of AP and DV signaling pathways by the homeotic gene Ultrabithorax during haltere development in Drosophila.

Suppression of wing fate and specification of haltere fate in Drosophila by the homeotic gene Ultrabithorax is a classical example of Hox regulation of serial homology (Lewis, E.B. 1978. Nature 276, 565-570) and has served as a paradigm for understanding homeotic gene function. We have used DNA microarray analyses to identify potential targets of Ultrabithorax function during haltere specification. Expression patterns of 18 validated target genes and functional analyses of a subset of these genes suggest that down-regulation of both anterior-posterior and dorso-ventral signaling is critical for haltere fate specification. This is further confirmed by the observation that combined over-expression of Decapentaplegic and Vestigial is sufficient to override the effect of Ubx and cause dramatic haltere-to-wing transformations. Our results also demonstrate that analysis of the differential development of wing and haltere is a good assay system to identify novel regulators of key signaling pathways.

Prevalence Of Cognitive Impairment Among The Members Of The National Council Of Senior Citizens’ Malaysia In Day Care Centres Within The Klang Valley

Cognitive Impairment is common in late life and may be due to the normal process of ageing, or associated with physical or mental disorder which contributes to a decrease in quality of life, neuropsychiatric symptoms, increased disability and increased healthcare cost. The aim of this study is to determine the prevalence of cognitive impairment among the elderly members in NACSCOM in Day Care Centres within the Klang Valley and its associated socio-demographic factors such as age, gender and educational level. This cross-sectional study was conducted on 101 members of NACSCOM in Day Care Centres of Damansara,Subang Jaya and Setapak using assisted questionnaires as the research tool. The questionnaire comprising of a total of 10 questions based on Elderly Cognitive Assessment Questionnaires (ECAQ), consisted of three parts, memory, orientation and recall. One correctly answered question earned the respondent one mark. The total score for ECAQ is 10 where respondents with scores of 5 and below were identified as having cognitive impairment. Data collected was analyzed using Chi-square test (SPSS version 18). The prevalence of cognitive impairment among the elderly members of NACSCOM in Day Care Centres within the Klang Valley was 4.0%. This study also showed that there was no statistically significant association between cognitive impairment and sociodemographic factors such as age, gender and education. Prevalence of cognitive impairment among the members of NACSCOM in Day Care Centres within the Klang Valley was found to be low. This could be attributed to the fact that members actively participated in activities organized by NACSCOM. The study also did not find any statistically significant association between cognitive impairment and age, gender and education.

Argatroban anticoagulation in patients with heparin-induced thrombocytopenia requiring renal replacement therapy.

BACKGROUND: Argatroban, a direct thrombin inhibitor, is used for prophylaxis or treatment of thrombosis in heparin-induced thrombocytopenia (HIT). The recommended initial dose is 2 microg/kg/min (0.5 microg/kg/min in hepatic impairment), adjusted to achieve activated partial thromboplastin time (aPTT) values 1.5-3.0 times baseline. However, few argatroban-treated patients with HIT and renal failure requiring renal replacement therapy (RRT) have been described. OBJECTIVE: To evaluate the safety and efficacy of argatroban anticoagulation during RRT in patients with HIT. METHODS: We retrospectively reviewed records from 47 patients with HIT and renal failure requiring RRT who underwent 50 treatment courses with argatroban. Patients with HIT had received argatroban during prospective, multicenter studies. Outcomes, safety, and dosing information were summarized. RESULTS: In the multicenter experience, no patient died due to thrombosis and 2 (4%) patients developed new thrombosis while on argatroban. No adverse outcomes occurred during argatroban reexposure. Starting doses were typically 2 microg/kg/min in patients without hepatic impairment and <1.5 microg/kg/min in those with hepatic impairment. Median (range) infusion doses were 1.7 (0.2-2.8) and 0.7 (0.1-1.7) microg/kg/min, respectively, with associated median (range) aPTT ratios, relative to baseline, of 2.2 (1.6-3.6) and 2.0 (1.4-4.1), respectively. Major bleeding occurred in 3 (6%) of 50 treatment courses. CONCLUSIONS: Argatroban provides effective anticoagulation upon initial and repeated administration in patients with HIT and renal impairment requiring RRT, with an acceptably low bleeding risk. Current dosing recommendations are adequate for these patients.

Argatroban and renal replacement therapy in patients with heparin-induced thrombocytopenia.

BACKGROUND: Argatroban, a direct thrombin inhibitor, is an effective anticoagulant for patients who have heparin-induced thrombocytopenia (HIT). Anticoagulation is usually required for renal replacement therapy (RRT). OBJECTIVE: To prospectively evaluate the pharmacokinetics, pharmacodynamics, and safety of argatroban during RRT in hospitalized patients with or at risk for HIT. METHODS: Five patients with known or suspected HIT underwent hemodialysis (n = 4) or continuous venovenous hemofiltration (CVVH, n = 1), while receiving a continuous infusion of argatroban 0.5-2 microg/kg/min. Activated partial thromboplastin times (aPTTs), activated clotting times (ACTs), argatroban concentrations (plasma, dialysate, CVVH effluent), and safety were assessed before, during, and after a 4-hour session of RRT. Systemic and dialytic argatroban clearances were calculated. RESULTS: Among the 4 hemodialysis patients, aPTT, ACT, and plasma argatroban concentrations remained stable during RRT, with respective mean +/- SD values of 74.3 +/- 34.2 seconds, 198 +/- 23 seconds, and 499 +/- 353 ng/mL before RRT, and 70.6 +/- 21.4 seconds, 181 +/- 12 seconds, and 453 +/- 295 ng/mL 2 hours after starting RRT (p values NS). Systemic clearance was 17.7 +/- 12.8 L/h before hemodialysis and 17.0 +/- 9.5 L/h during hemodialysis (n = 2). The dialyzer clearance (dialysate recovery method) was 1.5 +/- 0.4 L/h (n = 4). Generally similar responses occurred in the CVVH patient: systemic argatroban clearance was 4.8 L/h before CVVH and 4 L/h during CVVH. The hemofilter argatroban clearance was 0.9 L/h. No bleeding or thrombosis occurred. CONCLUSIONS: Argatroban provides effective alternative anticoagulation in patients with or at risk for HIT during RRT. Argatroban clearance by high-flux membranes during hemodialysis and CVVH is clinically insignificant, necessitating no dose adjustment.

Genetic characterization of the Drosophila homologue of coronin.

We report cloning and characterization of coro, which codes for the Drosophila homologue of the F-actin binding protein coronin. Viable alleles of coro produce a variety of phenotypes in leg, wing and eye development, which are similar to the phenotypes observed as a result of mutations in genes associated with the actin cytoskeleton and/or membrane trafficking. Homozygous lethal mutations in coro results in the disruption of the actin cytoskeleton in wing imaginal discs. Formation of both basolateral septate junctions and apical adherens junctions are also adversely affected in epithelial cells. Both viable and lethal alleles of coro show genetic interactions with syntaxin1A, a gene required for membrane trafficking. They also show enhanced response to over-expression of Decapentaplegic (Dpp) and its receptor Thick vein. Tracing of Dpp morphogen using a Dpp::GFP fusion construct suggested defects in the endocytic pathway, which resulted in uniform distribution of Dpp along the AP axis rather than a gradient from the AP boundary. Our results provide a genetic link between endocytosis/exocytosis events involving F actin-coated vesicles and the establishment of morphogen gradient.

Negative regulation of dorsoventral signaling by the homeotic gene Ultrabithorax during haltere development in Drosophila.

Growth and patterning during Drosophila wing development are mediated by signaling from its dorsoventral (D/V) organizer. In the metathorax, wing development is essentially suppressed by the homeotic selector gene Ultrabithorax (Ubx) to mediate development of a pair of tiny balancing organs, the halteres. Here we show that expression of Ubx in the haltere D/V boundary down-regulates its D/V organizer signaling compared to that of the wing D/V boundary. Somatic loss of Ubx from the haltere D/V boundary thus results in the formation of a wing-type D/V organizer in the haltere field. Long-distance signaling from this organizer was analyzed by assaying the ability of a Ubx(-) clone induced in the haltere D/V boundary to effect homeotic transformation of capitellum cells away from the boundary. The clonally restored wing D/V organizer in mosaic halteres not only enhanced the homeotic transformation of Ubx(-) cells in the capitellum but also caused homeotic transformation of even Ubx(+) cells in a genetic background known to induce excessive cell proliferation in the imaginal discs. In addition to demonstrating a non-cell-autonomous role for Ubx during haltere development, these results reveal distinct spatial roles of Ubx during maintenance of cell fate and patterning in the halteres.

A prospective comparison of three argatroban treatment regimens during hemodialysis in end-stage renal disease.

BACKGROUND: We prospectively evaluated 3 treatment regimens of argatroban, a direct thrombin inhibitor, for providing adequate, safe anticoagulation in patients with end-stage renal disease (ESRD) during hemodialysis. METHODS: In this randomized, 3-way crossover study, ESRD patients underwent hemodialysis sessions of 3- or 4-hour duration using high-flux membranes and each of 3 argatroban treatment regimens (A: 250-microg/kg bolus, with an additional 250-microg/kg bolus allowed; B: 250-microg/kg bolus followed by 2-microg/kg/min infusion; C: steady-state, 2-microg/kg/min infusion initiated 4 hours before dialysis). Pharmacodynamic effects including activated clotting times (ACTs); hemodialysis efficacy including single-pool Kt/V, urea reduction ratio (URR), and circuit flow; and safety through a 3-day follow-up were monitored. Argatroban pharmacokinetic parameters including dialytic clearance were evaluated during regimen C. RESULTS: Thirteen patients completed 38 hemodialysis sessions (1 patient withdrew consent after 2 sessions). Mean +/- SD ACTs increased from 131 +/- 14 seconds at baseline to 153 +/- 24, 200 +/- 30, and 197 +/- 33 seconds, respectively, after 60 minutes of hemodialysis using regimens A, B, and C. Across regimens, mean Kt/Vs (1.5-1.6) and URRs (70%-73%) were comparable. No dialyzer was changed; 1 session was shortened 15 minutes because of circuit clot formation. Systemic argatroban clearance increased approximately 20% during hemodialysis, without clinically significantly affecting ACTs. Upon argatroban discontinuation, ACTs and plasma argatroban decreased concurrently (elimination half-life, 35 +/- 6 min). No thrombosis, bleeding, serious adverse events, or clinically significant changes in vital signs or routine laboratory measures occurred. CONCLUSION: Argatroban, administered by each treatment regimen, provides safe, adequate anticoagulation to enable successful hemodialysis in ESRD patients. Argatroban dialytic clearance by high-flux membranes is clinically insignificant.