Marginal Bone Loss around Implants with Internal Hexagonal and Internal Conical Connections: A 12-Month Randomized Pilot Study

The aim of this study was to analyze the differences in terms of the marginal bone level (MBL) around implants with either an internal conical or an internal hexagonal implant–prosthesis connection. A randomized clinical trial included patients in need of a single implant-supported restoration. The implant–prosthesis connection was either internal conical or internal hexagonal while maintaining the same type of implant macro- and microarchitecture. Clinical and radiographical variables were registered up to 12 months of follow-up, including MBL. A total of 30 patients were included in the study. The main outcome variable, MBL 12 months after prosthesis delivery, was statistically different in both groups: −0.25 (0.12) vs. −0.70 (0.43) (conical vs. hexagonal; p = 0.033). Differences were also observed at the 3- and 6-month follow-up visits as well as for the MBL change from prosthesis delivery to the 12-month follow-up (−0.15 (0.13) vs. −0.56 (0.44); conical vs. hexagonal; p = 0.023). Correlations between MBL around the implants and radiographic measurements on the adjacent teeth, buccal bone to implant, tissue thickness or keratinized tissue were not significant neither globally nor when analyzed independently by group. In view of such results, it can be concluded that single-unit restorations with internal hexagonal-connection implants induce higher marginal bone loss after 12 months of follow-up from prosthesis delivery than internal conical-connection implants.

Immediate Procedural Success of Primary Percutaneous Intervention in Patients with Acute ST Segment Elevation Myocardial Infarction

Objective: To determine the frequency of immediate procedural success of Primary PCI in patients with Acute ST segment elevation Myocardial infarction. Methodology: This observational study was conducted at Cardiology unit of P.I.M.S, Islamabad from April 2018 to October 2018. Study included 43 patients with STEMI. All of them had primary PCI. The main outcome variable was frequency of procedural success which was described as frequency distribution table. Results: Procedural success was achieved among all (100%) patients. There were 16.3% patients who developed contrast induced nephropathy (recovered), they all were diabetics. There were 4.6% patients who developed hematoma. No other complications seen Conclusions: Immediate procedural success of primary PCI is high (almost successful in every case) and should be offered to the patients with STEMI whenever the facility is available. Keywords: ST-segment elevation myocardial infarction; primary percutaneous coronary intervention.

Training of vertical versus horizontal reading in patients with hemianopia – a randomized and controlled study

Hypothesis Patients with hemianopic field defects (HFD) might benefit from reading text in vertical orientation if they place the text in the seeing hemifield along the vertical midline. Methods We assigned 21 patients with HFD randomly to either vertical or horizontal reading training. They trained reading single lines of texts from a computer screen at home for 2 × 30 min/day, 5 days/week, for 4 weeks. The main outcome variable was reading speed (RS) during reading standardized paragraphs of printed text (IReST) aloud. RS was assessed before training (T1), directly after training (T2) and 4 weeks later (T3). Quality of life (QoL) was assessed by Impact of Visual Impairment (IVI) questionnaire. Results Vertical training improved RS in the vertical direction significantly. Only patients with right HFD benefited. Horizontal training improved RS in horizontal diection significantly, but much more in patients with left than in those with right HFD. Both effects remained stable at T3. RS during training at the computer improved highly significantly and correlated strongly with RS of printed text (Pearson r= > 0.9). QoL: Vertical training showed a statistically significant improvement in the complete IVI-score, patients with right HFD in the emotional IVI-score. Conclusions The improvements of RS were specific for the training. The stable effect indicates that the patients can apply the newly learned strategies to everyday life. The side of the HFD plays an essential role: Left-HFD patients benefitted from horizontal training, right-HFD patients from vertical training. However, the vertical RS did not reach the level of horizontal RS. The study was registered in the German Clinical Trials register (DRKS-ID: DRKS00018843).

An EBP to Promote Early Skin-to-Skin Care Intervention and Mother's Own Milk Feedings in the Extremely Low Birth Weight Population

PurposeDescribe an evidence-based process (EBP) to promote early skin-to-skin care (SSC) intervention and increase mother's-own-milk (MOM) feedings at discharge among extremely low birth weight (ELBW) infants.DesignThis EBP aimed to address the following clinical question: Among ELBW infants, does early SSC &#ξ2264;16 days of life (DOL), compared to SSC >16 DOL, result in more infants receiving MOM feedings at discharge?SampleA retrospective chart review of 199 ELBW infants.Main Outcome VariableEarly SSC intervention among ELBW infants and MOM at discharge.ResultsEarly SSC intervention increased from 46 to 73 percent among ELBW infants over the EBP period. Frequency of SSC intervention was associated with year of EBP and MOM at discharge (p = <.05). ELBW infants in the early SSC intervention group received more MOM at discharge.

The effect of thin lenticule versus thick lenticule (a cut-off value of 55 micrometer) on the outcome of SMILE in low myopia

Objectives: In the current study, the aim was to evaluate the effect difference in lenticule thickness SMILE cases (≤ 55 µm versus > 55 µm) on the visual outcome in a cohort of 61 patients with low myopia (≤3.0 diopters) Methods: The current prospective cohort study included 61 patients undergoing SMILE refractive procedure during the period extending from November the 14th 2019 through June the 14th 2020, a total of 99 eyes. The study was conducted in Ibsar ophthalmology surgery centre "private medical centre" in the wholly Najaf city, mid-Euphrates region of Iraq. The cases enrolled in the study were all operated on by the same ophthalmologist. According to lenticule thickness, eyes were classified into two groups, (≤ 55 µm versus > 55 µm). The main outcome variable was visual acuity postoperative within two short period of time, one week and 3 months. Results: Comparison of visual acuity between patients with lenticule thickness of ≤ 55 µm and patients with lenticule thickness of > 55 µm was shown in table 6. There was no significant difference in UCVA (uncorrected visual acuity) (P = 1.000), significant difference in BCVA (best corrected visual acuity) (better with lenticule thickness of ≤ 55 µm) (P = 0.037), no significant difference in VAAS (visual acuity after surgery) (P = 0.065) and no significant difference in VA3M (visual acuity 3 months after surgery) (P = 0.599). Conclusion: Thin lenticule of less than or equal 55 micrometer to as low as 41 micrometer can be chosen for SMILE with efficacy and safety comparable to that of thicker lenticule provided that the operation is done by well trained and skilled refractive surgeon.

Comparison of calcium hydroxide and chlorhexidine gel as intracanal medicament in relieving interappointment pain: Effect of gender and age.

Objectives: This study was done to compare calcium hydroxide (Ca(OH)2) and chlorhexidine (CHX) in relieving interappointment pain, in addition to observe influence of gender and age. Study Design: Randomized Control trial. Setting: Department of Operative Dentistry, Fatima Memorial Hospital, Lahore. Period: 3rd October 2016 to 20th May 2017. Material & Methods: 100 subjects were divided into 2 groups of 50, group A (Ca(OH)2) and group B (CHX). Information was recorded regarding the gender, age, intracanal medicament used, VAS pain scores of preoperative pain, 24 hours, 48 hours and on the 4th day of placing medicament. Change in pain scores was assessed as the main outcome variable. Results: VAS score mean difference for both medicaments was significant for 24 hours, 48 hours and 4th day (p < 0.0005. CHX medicament decreased pain more as compared to Ca(OH)2. Age had no significant effect on VAS score decrease but females had significant decrease in pain (p=0.04). Conclusion: CHX decreased the mean interappointment pain score more as compared to Ca(OH)2.

A Comparison of Moderate to Late Preterm Neonates Receiving Nasal Continuous Positive Airway Pressure in Australian Tertiary and Nontertiary Centers

PurposeTransfer of neonates ≥32 weeks' gestation with acute respiratory distress to tertiary (T) centers can be reduced by treatment with nasal continuous positive airway pressure (nCPAP) in nontertiary (NT) centers. This can lead to considerable financial and emotional benefits. The aim of this project was to compare management of nCPAP in T and NT centers.DesignFive-year retrospective, observational cohort study (2010–2014).SampleAll NT eligible neonates from four sites (n = 484) were compared with a similar randomized cohort of inborn neonates at two T centers (n = 601) in Victoria, Australia.Main outcome variableAny difference in management or short-term outcome.ResultsModerately preterm and term neonates born in NT centers had lower Apgar scores at five minutes of age and received more conservative management delivered by different equipment. Despite a higher incidence of air leaks in NT centers, the short-term outcomes were otherwise similar between centers. T centers were more likely to administer nCPAP to term babies for <24 hours.

Routine Gynaecological Operations Without Blood Transfusion

Objective : To establish the fact that most of the routine gynaecological operations need no blood transfusion. Method : This was a prospective observational study conducted in Dhaka Medical College Hospital from 15th January, 2011 to 14th April, 2011. Subjects were gynaecological patients admitted for routine operation. Main outcome variable was comparison of postoperative events between patients who received blood transfusion and who did not. Results : 40 gynaecological patients were operated without blood transfusion (Group I ) and 40 patients were taken who were operated with blood transfusion (GroupII ). Among the patients 35% in Group I and 42.5 % patients in Group II had some minor complications (hypotension, fever, wound infection and others) in postoperative period . The p value of of these postoperative complications in Group I is 0.020 and in Group II is 0.047 and r = 0.75 . The difference of pvalue is significant. No patient of any group sufferred from any major comcplication. Conclusion : There was no advantage of transfusing blood in routine gynaecological operation, rather more patients with blood transfusion had some minor postoperative complications. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 123-126

Multimodal Neurologic Enhancement Improves Preterm Infants' Developmental Outcomes: A Longitudinal Pilot Study

PurposeThe purpose of this study was to identify the long-term developmental effects of a NICU music therapy intervention, Multimodal Neurologic Enhancement, provided to preterm infants in the NICU.DesignProspective randomized controlled study with one control group and one experimental group.SampleParticipants were medically stable preterm infants with a birth age of 31 and 6/7 weeks or less, admitted to a level-III NICU. A total of 84 participants were enrolled, and 48 completed the study.Main Outcome VariablePost-discharge developmental scores on the Mullen Scales of Early Learning: AGS Edition.ResultsThe experimental group performed significantly better than the control group on the Visual Reception and Early Learning Composite scores.

Analysis of Factors Influencing the Prognostic Significance of Hyponatremia in Peritoneal Dialysis Patients

Background: The evidence linking low serum sodium levels with the risk of mortality in peritoneal dialysis (PD) patients is controversial. Considering the different mechanisms contributing to hyponatremia in these patients, it is conceivable that the prognostic significance of this factor may vary, according to the clinical setting. Methods: Following a retrospective, observational design, we analyzed the association between hyponatremia and mortality in 748 patients incident on PD. We applied multivariate strategies of analysis, with the main objective of identifying subgroups of patients in whom hyponatremia could sustain different degrees of association with mortality (main outcome variable). For this purpose, we performed preliminary analyses to: (1) disclose predictors of serum sodium levels before and after (mean of first 3 months) initiation of PD (main study variable) and (2) investigate the overall prognostic significance of hyponatremia, in our patients. Results: Comorbidity, hypoalbuminemia, and lower glomerular filtration rate (GFR) were main predictors of hyponatremia. Use of icodextrin was another inverse correlate of serum sodium, and the only consistent predictor of a decline of natremia, once PD was started. Multivariate analysis confirmed early hyponatremia as an independent marker of survival. However, stratified analyses showed that this association was most apparent in specific subsets, namely, hypoalbuminemic, more anemic patients with higher baseline levels of GFR and C-reactive protein and faster peritoneal solute transport rates. Other factors potentially reinforcing the prognostic significance of hyponatremia included lower lean body mass levels, nonprescription of renin-angiotensin-aldosterone system antagonists, and use of icodextrin-based PD solution. On the contrary, baseline overhydration or categorization by classic predictors of mortality (age, comorbidity, diabetes) did not appear to influence the risk pattern associated with lower serum sodium levels. Conclusions: Our results suggest that hyponatremia performs as a consistent correlate of the risk of mortality mainly in PD patients manifesting direct or indirect signs of inflammation and wasting, while this association is not apparently linked to the presence of overhydration or nominal, preexisting comorbid conditions.