Radiographic and Histologic Assessment of Eggshell Derived Hydroxyapatite as a Bone Graft Substitute in Extraction Sockets

BACKGROUND: For success of the implant placement adequate alveolar ridge width and height should be available. Resorption is a natural phenomenon following tooth extraction. To prevent the extracted socket, socket preservation is done using bone grafts. Most of the commercially available bone grafts are expensive to produce. Egg shell derived hydroxyapatite bone graft substitute is a cost- effective and easily available material. Although eggshell grafts are reported to be biocompatible, no reports on histologic evaluation of the grafted site in humans have been reported. Therefore, this study design includes radiographic and histologic evaluation of eggshell derived hydroxyapatite as a bone graft substitute in extracted sockets in humans. AIM AND OBJECTIVES: To evaluate the efficacy of eggshell derived hydroxyapatite as a bone graft substitute in extraction sockets in humans and also to evaluate the bone regeneration capacity radiographically on 1st, 3rd and 5th month, and histologically on 6th month. MATERIALS AND METHODS: Total of 10 patients were recruited based on inclusion and exclusion criteria. The tooth extraction was done under local anesthesia. Gentle curettage followed by thorough sterile saline irrigation of the socket was done. Egg-shell derived hydroxyapatite grafting material was hydrated with sterile saline and placed inside the socket. The bio-resorbable guided tissue regeneration membrane was placed and the flaps were sutured. Patient was recalled after 15 days for suture removal and to inspect for any signs and symptoms of infection or any other complications. Digital radiographs (Radiovisiography) were taken preoperatively, immediate post-operative, 1st, 3rd and 5th month of graft placement. Bone was harvested from the grafted site on 6th month of graft placement for histologic analysis. RESULT: Bone harvested from the grafted site revealed signs of new bone formation on histologic examination. Radiographic analysis showed that the changes among bone density between 1st, 3rd and 5th month were not significant (p ˃ 0.05). CONCLUSION: Eggshell derived hydroxyapatite graft is an efficient bone graft substitute. This graft substitute is biocompatible, cost-effective and obtained from easily available material. Because of these characteristics, eggshell derived hydroxyapatite graft is a feasible material of choice for regenerative capacity

Zinc Oxide-Based Endodontic Sealer with Proanthocyanidin-PLGA Nanoparticles: Synthesis and Physical Characterization

This study developed a zinc oxide-based endodontic sealer incorporating proanthocyanidin nanoparticles (PAC-NPs) encapsulated in poly(lactic-co-glycolic acid) (PLGA), utilizing PAC’s proven ability to enhance dentine collagen stability. The formulation was designed to provide both antimicrobial and collagen-stabilizing benefits, aiming to improve dentine-sealer interface integrity and prolong the functional lifespan of root canal treatments. Chemical characterization was conducted using Fourier Transform Infrared (ATR-FTIR) spectroscopy, confirming the presence of Zn-O and C=O bonds, indicative of the successful integration of zinc oxide and encapsulated PAC. Physical properties, including flow, setting time, solubility, and dimensional stability, were evaluated according to ISO 6876:2012 and ANSI/ADA standards 57, with the sealer meeting all clinical performance criteria. This preliminary characterization of the physical and chemical properties establishes a basis for further in vitro studies on the mechanical and biological performance of the sealer, aimed at validating its potential to enhance dentine collagen stabilization and material durability in endodontic applications

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Gender preferences among antenatal women: a cross-sectional study from coastal South India

Background: A balanced sex ratio is essential for a stable society.Objective: The main objective of the present research was to study the perceptions of women attending the antenatal care (ANC) facility regarding their gender preferences and family composition.Method: In this cross-sectional study 132 antenatal women were interviewed in their preferred language using a predesigned semi-structured questionnaire. The collected information was analyzed using SPSS version 11.5.Results: The mean age of the study participants was 27.2 ± 4.1 years. The majority of the antenatal women (60.6%, n=80) did not have any gender preferences. Among those who had a gender preference (39.4%, n=52), male and female preference was reported by 55.7% (n=29) and 44.3% (n=23) of the participants respectively. The overall son preference index was observed to be 1.3. No consistent relationship could be established between the socio-demographic factors and the preference for gender. The mean preferred family size in our study was 1.85±0.531 and more than half of the participants had a balanced gender preference. The majority of the participants were aware that the adverse sex ratio can lead to fall in the number of brides and that it would bring about a social imbalance.Conclusion: As a developed society we need to ensure that both the genders get equal respect and are free from any sort of preferences and prejudices. To achieve this, more and more people need to be made aware of the consequences of gender imbalance and adverse sex ratio in a society.Keywords: Gender preferences; family composition; antenatal women; coastal South Indi

Mutations at positions 186 and 194 in the HA gene of the 2009 H1N1 pandemic influenza virus improve replication in cell culture and eggs

Obtaining suitable seed viruses for influenza vaccines poses a challenge for public health authorities and manufacturers. We used reverse genetics to generate vaccine seed-compatible viruses from the 2009 pandemic swine-origin influenza virus. Comparison of viruses recovered with variations in residues 186 and 194 (based on the H3 numbering system) of the viral hemagglutinin showed that these viruses differed with respect to their ability to grow in eggs and cultured cells. Thus, we have demonstrated that molecular cloning of members of a quasispecies can help in selection of seed viruses for vaccine manufacture

Aluminium doped ZnO nanostructures for efficient photodegradation of indigo carmine and azo carmine G in solar irradiation

Aluminium doped zinc oxide (AZO) nanomaterials (AlxZn1-xO) with x fraction varying as 0.02 and 0.04 were synthesized using the auto-combustion method using glycine as a fuel. The synthesized catalysts were characterized with X-ray diffraction (XRD), UV–Visible Spectroscopy (UV–Vis), Raman spectroscopy, Photoluminescence (PL) spectroscopy, and High Resolution Transmission Electron Microscopy (HR-TEM). XRD results showed that synthesized materials possessed good crystallinity, while UV–VIS was employed to find the band gaps of synthesized materials. Raman was used to determine the vibrational modes in the synthesized nanoparticles, while TEM analysis was performed to study the morphology of the samples. Industrial effluents such as indigo carmine and azo carmine G were used to test the photodegradation ability of synthesised catalysts. Parameters such as the effect of catalyst loading, dye concentration and pH were studied. The reduction in crystallite size, band gap and increased lattice strain for the 4% AZO was the primary reason for the degradation in visible irradiation, degrading 97 and 99% equimolar concentrations of indigo carmine and azo carmine G in 140 min. The Al doped ZnO was found to be effective in faster degradation of dyes as compared to pure ZnO in presence of natural sunlight.This work was supported by an NPRP grant from the Qatar National Research Fund under NPRP12S-0131–190030

Unraveling the genetic architecture of subtropical maize (Zea mays L.) lines to assess their utility in breeding programs

Background Maize is an increasingly important food crop in southeast Asia. The elucidation of its genetic architecture, accomplished by exploring quantitative trait loci and useful alleles in various lines across numerous breeding programs, is therefore of great interest. The present study aimed to characterize subtropical maize lines using high-quality SNPs distributed throughout the genome. Results We genotyped a panel of 240 subtropical elite maize inbred lines and carried out linkage disequilibrium, genetic diversity, population structure, and principal component analyses on the generated SNP data. The mean SNP distance across the genome was 70 Kb. The genome had both high and low linkage disequilibrium (LD) regions; the latter were dominant in areas near the gene-rich telomeric portions where recombination is frequent. A total of 252 haplotype blocks, ranging in size from 1 to 15.8 Mb, were identified. Slow LD decay (200-300 Kb) at r2 <= 0.1 across all chromosomes explained the selection of favorable traits around low LD regions in different breeding programs. The association mapping panel was characterized by strong population substructure. Genotypes were grouped into three distinct clusters with a mean genetic dissimilarity coefficient of 0.36. Conclusions The genotyped panel of subtropical maize lines characterized in this study should be useful for association mapping of agronomically important genes. The dissimilarity uncovered among genotypes provides an opportunity to exploit the heterotic potential of subtropical elite maize breeding lines

Letter to the Editor

Background Disaster, whether man made or natural, may occur at any place or time. This study was conducted to assess the preparedness of hospitals in handling emergencies as per District Disaster Management Plan (DDMP) at Mangalore, a coastal city on the Western coast of Karnataka. Method A cross sectional study was conducted in 12 hospitals of Mangalore city, located at the Southwestern coast of India in April 2009, using a semi-structured proforma. All surveyed hospitals were included in the DDMP. The respondents were hospital administrators. Results Though all the hospitals surveyed were aware about the existence of DDMP in the district of Dakshina Kannada, 6 (50%) were unaware that their hospitals were included in the same plan. Out of 12 hospitals, 4 (33.3%) said that they had got a letter from DDMP, spelling out their responsibilities. Only 6 (50%) hospitals had a contingency plan for emergency. Mock drill was conducted only by 6 (50%) hospitals. Six (50%) hospitals had blood bank, 5 (41.6%) had trauma center and 8 (66.6%) had burns ward available for emergency. Half of them had more than 2 ambulances and 10(83.3%) had sufficient stock of medicines. Extra beds for emergency were available in 11(91.7%) hospitals with maximum number of 42 beds in one hospital. Conclusion; Most hospitals in Mangalore were not well prepared to manage emergencies in disasters. Facilities like burns ward, blood bank and ambulance services need to be enhanced

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill &amp; Melinda Gates Foundation

Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019

Background Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−28·4 to −2·9) for all diabetes, and by 21·0% (–33·0 to −5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (−13·6% [–28·4 to 3·4]) and for type 1 diabetes (−13·6% [–29·3 to 8·9]). Interpretation Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations.publishedVersio