Effects of Homemade Nano-Hydroxyapatite and Olive Oil Paste on Remineralization of Early Caries Lesions

Nano-hydroxyapatite (nHAP) particles are a new generation of materials reported to remineralize enamel lesions. The purpose we aimed was to compare the in vitro effects of fluoride gel, sodium fluoride toothpaste, and homemade nHAP paste on remineralizing artificial early enamel caries. Methods: Incipient caries were induced in 21 extracted, sound premolar teeth by storing each specimen in a demineralization solution for 72 hours, followed by pH cycling. The samples (n= 7, each) were then treated with 2% neutral fluoride gel, 0.25% sodium fluoride toothpaste, or homemade nHAP paste, comprising a mixture of nHAP powder and olive oil. After demineralization and remineralization, the results were compared using the DIAGNOdent pen (KaVo, Germany). The data were statistically analyzed using paired t-tests and a one-way ANOVA test. Outcomes: The degree of demineralization in each of the three groups (fluoride gel group, 15.71; sodium fluoride dentifrice group, 15.28; nHAP paste group, 16.71) was significantly elevated compared to baseline (3, 2.5, 2.28, respectively); however, no significant difference was observed between the remineralization readings in each of the three groups (6, 7, 5.5, respectively) (p > 0.05). In conclusion, we concluded that the homemade nHAP paste had a beneficial effect on the remineralization of initial enamel caries lesions.

Adherence to Vaccine Requirements among Hajj Pilgrims in Saudi Arabia, 2017-2019

Hajj pilgrims must have certain vaccines for pilgrimage; these requirements aim to reduce the spread of infectious diseases. This study analyzed the trends in vaccine adherence for meningitis, yellow fever, and polio from January 2017- December 2019. These trends can help in guiding future policymaking to prevent outbreaks during Hajj and similar mass gatherings. We analyzed data using descriptive statistics for Hajj pilgrims and Hajj seasonal workers arriving in Saudi Arabia over three years (2017–2019). Health Control Centers (HCCs) collected data at points-of-entry (PoE) and entered it into Saudi Arabia’s Health Electronic Surveillance Network (HESN). We reviewed HESN data to collect information on total passengers arriving per country and the number of passengers vaccinated for: meningococcal meningitis, poliomyelitis, and yellow fever. We compared data to identify the difference in vaccination by region. We used chi-square tests to assess differences in compliance rate among these travelers by year and country of origin. The number of participating countries increased from 113 to 132. Meningitis vaccine coverage increased by 5% from 2017–2019. The increase was not statistically significant. Asia had the lowest overall adherence rate (83%). Yellow fever adherence decreased significantly using a difference of mean adherence between 2017 and 2019 (p-value 0.01). Polio vaccination adherence decreased by 5% from 2017 to 2019; this was not significant (p-value = 0.08). The vaccine coverage increased for meningitis and decreased for yellow fever and polio. Less than 100% vaccine adherence among Hajj travelers creates the potential for the spread of infectious diseases. Proof of vaccination should be required in submitted visa applications. Countries of origin and Saudi Arabia must work together to ensure that all Hajjis are adequately vaccinated before departure.

Bacterial Contamination that Causes Food Poisoning in Fruit Salads in Banjarbaru Indonesia

Fruit salad is one food combination that often causes food poisoning because it contains cheese and milk. This study aims to analyze the bacterial contamination that causes food poisoning in fruit salads sold in Banjarbaru, Indonesia, and the factors that play a role in such pollution. Food poisoning from fruit salad can be anticipated by knowing bacterial contamination and the factors that play a role in it. This study uses an observational method with a cross-sectional design. The sample in this study was fruit salads from 18 different producers sold in Banjarbaru, Indonesia. Fruit salad with criteria containing fruit, cheese, and mayonnaise. The bacteria that caused food poisoning to find in the fruit salad, namely Staphylococcus aureus, and Bacillus cereus. In conclusion, his research found the contamination of bacteria that cause food poisoning in Fruit Salad in Banjarbaru City with a percentage of 22 percent. The types of bacteria are Staphylococcus aureus (11 percent) and Bacillus cereus (11 percent). It recommends that salad sellers wash their hands before processing, use running water to wash fruit, and use secure salad packaging.

Analysis of Adolescent Hemoglobin Levels on Knowledge, Body Mass Index, and Menstrual Patterns

Anemia can be related to several factors, including knowledge, body mass index, and menstrual patterns. Adolescent girls are a high-risk group who experience anemia. This study aims to analyze the hemoglobin levels of adolescent girls about knowledge, body mass index, and patterns menstrual. Information on the relationship between hemoglobin levels and these factors expects to be a reference for strategies to overcome anemia in adolescent girls. The sample of this research is the students of Martapura Indonesia vocational high school, totaling 45 people. Data collection includes weight and height measurements, hemoglobin examination (using Easy Touch GCHb), and questionnaires. Data analysis used bivariate analysis of chi-square test with 0.05 with 95% confidence degree. Results Respondents had fewer hemoglobin levels 47%, normal 53%. The body mass index value of respondents is less than 85%, normal 13%, excess 2%. The respondent's menstrual pattern obtained 26% abnormal data, 74% normal data. Knowledge of anemia of respondents with enough category 34%, good category 66%. The conclusion is that there is no relationship between hemoglobin levels and body mass index (p-value 0.281), menstrual patterns (p-value 0.073), and knowledge of anemia (p-value 0.402) in adolescent girls. Hemoglobin levels may more influence by the consumption pattern of foods containing iron, so it recommends that young women consume more iron-rich foods and avoid the simultaneous consumption of substances that inhibit their absorption, such as tea and coffee.

Isolation and Molecular Characterization of Klebsiella And Enterobacter Species Recovered in Sunflower Seed Agar from Cases Resembling Respiratory Cryptococcosis

Respiratory cryptococcosis caused by Cryptococcus species can present with symptoms indistinguishable from bacterial or viral etiology. Cryptococcus species produce typical colonial features on Sunflower Seed Agar (SSA), which aids in rapid diagnoses of cryptococcosis. In studying respiratory cryptococcosis, we observed bacterial growths on SSA that resembled Cryptococcus species in colonial characteristics. This study aimed at identifying and characterizing those bacterial isolates for documentation. Sputum samples were collected from 201 patients with symptoms suggestive of respiratory cryptococcosis. The samples were inoculated onto SSA, incubated at 37oC for two weeks. Suspected colonies were further evaluated. Of the samples, none yielded Cryptococcus species, although a total of twenty Cryptococcus-resembling bacterial colonies were encountered and isolated. Eight of the isolates could not amplify by PCR techniques. The other twelve were identified as follows: Klebsiella pneumonia (8 or 67%), Klebsiella ozaneae (3 or 25%), and Enterobacter ludwigii (1 or 8%). All isolates were susceptible to Ertapenem, Meropenem, and Fosfomycin but resistant to ampicillin. Results show that Klebsiella and Enterobacter pneumonia-like illnesses can be misidentified as cryptococcosis using SSA. Reliance on microscopic rather than macroscopic, colonial features on SSA will prevent misdiagnosis.

Acquired Ano Rectal Conditions (AARC) in Children Seen at Gezira National Center for Pediatric Surgery (GNCPS-Sudan), Epidemiology, Management, and Outcome

The study's main objective is to determine the epidemiology, treatment, and outcome of the acquired anorectal conditions seen at the GNCPS. This study was a retrospective and prospective descriptive hospital-based study involving (131) child with Acquired anorectal conditions (AARC) who presented to GNCPS during the two-year study period. Data regarding the presentation, management, and post-operative course to look after complications and outcomes were collected. Data were collected using a formulated questionnaire and analyzed using (SPSS 17). Data considered statistically significant when P-value is less than 0.05. The study involved a total number of 131 children with AACS. The mean age of presentation is (5.78 years) with an overall 1.4:1 male to female ratio. Most of the study subjects are from rural areas, 66.4 percent. Most of them treated surgically, 83.2 percent, and 16.8 percent medically, with an overall complication rate of 24.4 percent. Conclusion Acquired Ano Rectal Conditions commonly seen at the preschooler age, mean (5.78 years). Rectal polyps and rectal prolapse were among the most frequently seen acquired anorectal conditions in children. Most of the cases treated surgically with an overall complication rate of 24.4 percent.

Effect of COVID-19 Pandemic on Mental Health in Patients with Kidney Transplantation

Severe acute respiratory syndrome coronavirus-2 is the cause of coronavirus disease 2019 (COVID-19). The most effective method in controlling the disease is maintaining the distance between people and, if necessary, quarantine. Recent evidence suggests that people kept in isolation and quarantine experience significant anxiety, confusion, and stress levels. This study aims to investigate the effects of COVID-19 on mental health in kidney transplant recipients. In this cross-sectional study, all renal transplant patients who followed up in our transplantation clinic were evaluated to be included in the study. The Turkish version of the fear of COVID-19 scale, depression anxiety stress scale (DASS-21), and satisfaction with life scale (SWLS) were administered to the patients. Patients were interviewed face-to-face by the same physician. A total of 68 patients were included in the study: 29 (42.6 percent) women and 39 (57.4 percent) men. In the present study, we detected that DASS-21 anxiety, depression, stress, and total scores were higher in patients with a family history of psychiatric disease than without (p<0.05). We did not find any statistical differences between patients’ demographic characteristics and fear of COVID-19 scale, DASS-21 anxiety, depression, stress, and total scores except for family history of psychiatric disease. More extensive and multi-center studies are needed to determine these patients' anxiety and depression states in the future.

Prevalence and Pattern of Diabetic Ketoacidosis among Children an Enugu, Southeast Nigeria: a 10 Year Retrospective Study

Diabetic ketoacidosis (DKA) is the most severe complication in pediatric cases of type 1 diabetes and also the leading cause of death in these children. There is a broad geographic variation in the frequency of DKA at the onset of diabetes. This study sought to determine DKA's prevalence and pattern in Enugu and review the treatment and outcome over ten years. This retrospective study conduct in the Children Emergency Rooms (CHER) of the two tertiary institutions in Enugu State, southeast Nigeria: Enugu State University Teaching Hospital (ESUTH) and the University of Nigeria Teaching Hospital (UNTH). The biochemical criteria for the diagnosis of diabetic ketoacidosis (DKA) base on the presence of hyperglycemia (blood glucose > 11 mmol/L), acidosis (serum bicarbonate < 15 mmol/L), and ketonuria (urine ketone ?1+). A total of 16,488 children were admitted during the ten years, of which 21 children presented with DKA, representing a prevalence of 0.13%. Six (28.6%) of the patients were newly diagnosed diabetics, while fifteen (71.4%) known diabetics, of which 9 (60%) were presenting with DKA for the first time. A total of two patients died, giving a mortality rate of 9.5%. The rest treated and discharged. The total hospitalization duration ranged from 1–31 days, with a mean duration of 13.3 ± 7.5 days. This study has revealed some of the challenges with the management of children with DKA and the unacceptably high mortality rate.

Intrauterine Insemination Success Rates Between Patients TSH Level of 2.5 mIU/L and 2.5-4.5 mIU/L

The aim of this study to assess whether there is a need to decrease the TSH level below 2.5 mIU/L in unexplainable infertility patients who were undergoing intrauterine insemination and determining the difference between patients with a TSH level of 2.5 mIU / L and patients with a TSH level of 2.5-4.5 mIU/L in terms of the success of intrauterine insemination. This study conduct via cross-sectional examinations of the 272 patients who applied to Ümraniye Training and Research Hospital infertility outpatient clinic between 01.06.2017-01.10.2019, who underwent intrauterine insemination with the diagnosis of unexplained infertility. Results research the mean age of the cases participating in our study is 31.65 ± 5.28, and the mean BMI measured as 24.17 ± 4.30 kg / m2. TSH values range from 0.3 to 5.2, with an average of 1.84 ± 0.93; while TSH value of 174 cases (77.3%) is below 2.5 mIU/L, TSH value of 51 cases (22.7%) is between 2.5-4.5mIU/L. Within the control group with TSH <2.5 mIU/L, the cycle was canceled in 13 cases (7.5%), pregnancy did not occur in 143 cases (82.2%). While ongoing pregnancy was achieved in 17 cases (9.8%), clinical pregnancy was achieved in 1 case (0,6%). Also, within the study group with a TSH value of 2.5-4.5 mIU/L, cycles were canceled in 7 cases (13.7%), pregnancy did not occur in 40 cases (78.4%), and ongoing pregnancy was achieved in 4 patients (7.8%). There was no statistically significant difference in terms of intrauterine insemination success between the control group with TSH <2.5 mIU / L and the study group with TSH 2.5-4.5 mIU/L. Widespread randomized controlled prospective studies need to determine the optimal TSH threshold value before TSH treatment of the women receiving infertility treatment.

Outcome Analysis Following Microvascular Free Gracilis Muscle Transfer for Multi-Vector Facial Reanimation

The purpose of this research to address objective excursion and symmetry results from a series of free gracilis muscle transfer (FGMT) cases and examine the predictive intraoperative number of vectors anchored during flap inset on outcomes. A retrospective analysis performs by data retrieved from the HUSM Plastic & Reconstructive Surgery OR Registry from January 2005 to June 2019. All patients who reported facial nerve palsy were recorded and re-evaluated. All characteristics in interest were epidemiologically tabulated and analyzed in detail. Subsequently, outcome assessment was performed to look for facial symmetry and smile excursion compared to the healthy side of the face—this study exempted by the Institutional Review Board of the Hospital of University of Sciences Malaysia. Out of 12 patients diagnosed with facial palsy, four patients underwent static facial reanimation. Eight patients underwent a dynamic facial reanimation, with 4 of them completed two stages of cross-facial nerve grafting (CFNG) and free gracilis muscle transfer (FGMT). One of the FGMTs patients had missed a follow-up. The mean age was 20 (range 11 to 30), one patient was male, and two were female. The mean duration for follow-up was 69 months. The mean duration of operating time was 8.67 hours. All operations without complication, and there was no microvascular re-exploration. Smile excursion and angle excursion at smile improved following FGMT. Association between the number of vectors anchored during flap inset to the outcome were identified. Dynamic facial reanimation using FGMT still the gold standard of treatment, which provides an excellent quantifiable improvement in oral commissure excursion and facial symmetry with smiling. The use of multivector gracilis flap was suggestive to associate with the good outcome on excursion and symmetrical of the smile.