In-vitro Comparative Evaluation of Flexural Strength and Depth of Cure of Bulkfill Composite

Aims and objectives: Bulkfill composite resins have been used for the posterior restorations in an attempt to speed up the restorative process. Here 4 to 5mm thickness of composite resins can be placed andcured in asingle step so that time consuming layering technique can be eliminated. The purpose of this study was to investigate the flexural strength and depth of cure of two bulk fill composites and to compare it with a universal composite. Materials and method: Two bulk fill composites (Sonic fill and Filtekbulkfill) and one universal composite (Filtek Z350 XT) were used. Ten samples per group were made using rectangular split brass mold following ISO standard 4049 to measure the flexural strength. Each sample was then subjected to three point bend test using universal testing machine until failure occurred. For depth of cure measurements, ten samples per group were made using cylindrical brass mold and were subjected to acetone shake test for 30 sec. The dimensions of the samples were measured using Vernier callipers and compared. One-way analysis of variance followed by Tukey’s post-hoc test was used to determine the statistical differences among groups at significance of p<0.05. Results: Sonicfillgave highest flexural strength value and Filtek Z350 XT the least. There was no statistically significant difference between the flexural strength of Filtekbulkfill and Filtek Z350 XT. For depth of cure, Filtekbulkfill showed higher value than other tested groups. Conclusion: All the tested materials showed significantly higher flexural strength values than the minimum flexural strength (80MPa) that is required for use in stress bearing areas. Sonicfill composite produced highest value of flexural strength than other composites, which may bedue to its increased percentage of filler content. For depth of cure, both the tested bulkfill composites showed lesser value of depth of cure than that claimed by manufacturers .

Evaluation of vaccine storage and cold chain management practices during intensified mission Indradhanush in community health centers of Tikamgarh district of Madhya Pradesh

Background: Vaccination is one of the most effective disease prevention strategies and potency of vaccine is dependent on effective management of cold chain at all levels of vaccine handling. An effective cold chain maintenance system is the backbone of success of any immunization program. This study was done to assess the cold chain management and vaccine storage practices in Tikamgarh district of Madhya Pradesh.Methods: Cross-sectional study was carried out using a structured questionnaire.Results: Dedicated room/space for dry storage not available in any of 03 CHCs. Dedicated table for conditioning of icepacks, dedicated clean clothes for wiping of icepacks after conditioning and power back up was available, ILR and DF were connected to separate functional voltage stabilizer and thermometers were placed correctly only in 66.6% CHCs. ILRs and DFs were properly placed, cabinet temperature of ILR and DFs was maintained in normal range in all the three (100%) CHCs. Record of power failure, records of defrosting/cleaning was maintained in temperature log book and cold chain handlers had knowledge of shake test in only 33.3% CHC.Conclusions: Proper vaccine storage and management of cold chain system is essential for immunization. In order to improve quality of immunization services there is a need of space, temperature monitoring and regular defrosting with record keeping and regular training of cold chain handlers to keep their knowledge and skills updated. Monitoring and supervision of cold chain points by DIO should be on regular basis.

Assessment of cold chain and logistics management practices: a cross sectional study in Bundelkhand region of Madhya Pradesh

Background: Immunization is one of the most effective disease prevention strategies. Potency of vaccine is dependent on effective management of cold chain system at all levels of vaccine handling. This study was carried out to assess the status of cold chain equipment and logistics management practices, Knowledge and practice of CCHs about cold chain equipment and logistics management.Methods: Cross-sectional study was conducted in all functional cold chain points of Damoh district using structured questionnaires provided by UNICEF.Results: Only 57.14% and 71% CCPs had dedicated space for dry storage and for conditioning of ice packs respectably. 50% CCPs had correct placement of ice-packs inside DFs. Functional thermometer inside every equipment was available in 86% CCPs. Twice daily temperature recording and temperature of ILRs was within normal range in 93% CCPs. Record of power failures and defrosting/cleaning in temperature log books was found in 57% and 43% CCPs. Temp log book was countersigned by facility in charge in 43% CCPs. UIP vaccines were stored within basket in 93%. Fractional IPV was stock out in 29% CCPs and in 07% CCPs OPV vials were found with not usable VVM. 86%, 72% and 64% of CCHs had knowledge on freeze/temperature sensitive vaccines, cold chain pray and, Shake test. In 79% CCPs expired/wasted vaccines were not documented in stock.Conclusions: Most of the components of cold chain and logistics management practices were satisfactory while there is a gap in other components which needs to be improved.

The prevalence of hyaline membrane disease and the value of shake test and lamellar body concentration in preterm infants

Background The morbidity and mortality of hyaline membrane dis-ease (HMD) are quite high due to delayed diagnosis and intervention.Commonly, HMD occurs in preterm infants with surfactant deficiencybecause of lung immaturity. Lung maturity test could be performedusing biochemical, biophysical, and amniotic fluid turbidity test.Objective To find out HMD prevalence and the value of shaketest and lamellar body concentration in diagnosing HMD in preterminfants.Methods This was a cross-sectional study carried out at HasanSadikin Hospital Bandung on preterm infants born during October-December 2001. The shake test was performed using gastric fluidand amniotic fluid while the lamellar body concentration was per-formed using amniotic fluid.Results During the 3-month period, 571 infants were born, of 64(11.2%) preterm infants, only 41 (64%) fulfilled the inclusion crite-ria; among those preterm infants, 14 (34%) suffered from respira-tory distress and 7 suffered from HMD (prevalence 17%). All HMDcases occurred in infants less than 32 weeks for gestational age.In 7 preterm infants with HMD, the shake test of gastric fluid ob-tained by lavage showed negative results in 3 and +1 in 4 infants;while the shake test of amniotic fluid revealed negative result in 5and +1 in 2 infants. Lamellar body concentration of amniotic fluidwas ≤18,000/ml in all HMD infants. Among three infants less than32 weeks for gestational age who did not suffer from HMD, +1shake test of gastric fluid was found in 2 infants and +2 in 1 infant;while shake test of amniotic fluid showed negative result in 1 infantand +1 in 2; the lamellar body concentration of amniotic fluid was≤18,000/ml in 2 infants and >18,000/ml in 1 infant.Conclusions We concluded that HMD occurred in 17% of preterminfants. The shake test of gastric and amniotic fluids revealed nega-tive or +1 results whereas lamellar body concentration had valueof less than or equal to 18,000/mL. More extensive studies arewarranted to assess the validity (sensitivity, specificity and predic-tive values) of these measurements

Comparison of Reliability of Tap Test and Shake Test for Determination of Fetal Lung Maturity

Aims: To compare the reliability of tap test and shake test for determination of fetal lung maturity in pregnant women between 28 weeks and 36 completed week’s gestation either with preterm prelabour rupture of membrane or preterm labour. Methods: Amniotic fluid samples from vaginal pool were obtained from one hundred pregnant women who met the inclusion criteria. Both tap test and shake test were performed in each sample. All deliveries occurred within 72 hours of collection of amniotic fluid. The results of the tests were compared with the incidence of neonatal respiratory distress syndrome. Results: Out of 100 tests performed, tap test predicted 17% as immature and 83% as mature and shake test predicted 51% as immature and 49% as mature. Among 100 newborns, 9 (9%) were found to be true immature as they developed respiratory distress syndrome. The sensitivity, specificity, predictive value for fetal lung immaturity and maturity by tap test was 88.9%, 90.1%, 47.1% and 98.8% respectively and the sensitivity, specificity, predictive value for fetal lung immaturity and maturity by shake test was 100%, 53.8%,17.6% and 100% respectively. Conclusions: In view of very low specificity and predictive value for fetal lung immaturity by shake test compared to that by tap test and lower sensitivity of the tap test than the shake test, neither of the tests is reliable than the other and these two tests can not replace each other DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11141 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 36-39