Following Surgically Assisted Rapid Palatal Expansion, Do Tooth-Borne or Bone-Borne Appliances Provide More Skeletal Expansion and Dental Expansion?

Abstract Purpose: The aim of this study is to compare the outcome measures of skeletal and dental expansion with Bone-Borne (BB) versus Tooth-Borne (TB) appliances following SARPE. This study is being done to provide quantitative measurements that will help the oral surgeon and orthodontist in selecting the appliance with, on average, the greatest amount of skeletal expansion and the least amount of dental expansion. Methods: A computerized database search was performed using PubMed, EBSCO, Cochrane, Scopus, Web of Science, and Google Scholar on publications in reputable oral surgery and orthodontic journals. A systematic review and meta-analysis was then completed with the predictor variables of expansion appliance (TB versus BB) and outcome measure of expansion (in millimeters). Results:A total of 487 articles were retrieved from the six databases. 5 articles were included, 4 with CBCT data and 1 with non-CBCT 3D cast data. There was a significant difference in the skeletal expansion (SMD = 0.92, 95% CI [0.54, 1.30], p = Conclusion: The literature points to the fact that in order to achieve more effective skeletal expansion and minimize dental expansion after SARPE, a Bone-Borne (BB) appliance should be favored. Keywords: Bone Borne; Tooth Borne; Rapid Palatal Expansion; SARME; SARPE; Surgically Assisted Rapid Palatal Expansion; Surgically Assisted Rapid Maxillary Expansion

Molecular diagnosis of Mycoplasma spp. Arthritis by PCR

Background: Arthritis is one of the most common inflammatory diseases worldwide. It is characterized by symptoms such as systemic inflammation and autoantibody production. The molecular mechanisms in pathogenesis of arthritis are not fully understood. Studies show that many microorganisms, including Mycoplasmas, play a role in arthritis. The PCR method is a fast and accurate molecular method for the detection of Mycoplasma genus. The main objective of this study is the detection of Mycoplasma spp arthritis by PCR method.Methods: In this study, 70 samples of synovial fluid collected from Shariati hospital. DNA samples were extracted by phenol-chloroform standard method. Using several Mycoplasma standard strains and 16S rRNA gene target optimized PCR test of Mycoplasma spp. Sensitivity and specificity test were performed on the basis of standard methods and then performed on the DNA extracted of samples.Results: PCR product was amplified by 272 bp and was observed on 2% gel electrophoresis. Specificity test with DNA of other microorganisms showed 100% specificity of these primers. The limit of detection was evaluated 100 copy/reaction. From 70 samples of synovial fluid, 2 samples (3%) were positive and 68 cases (97%) were negative.Conclusion: This study showed that a number of infectious arthritis are Mycoplasma spp at the same time, and the PCR technique can be used as a sensitive and accurate way of early detection of Mycoplasma spp arthritis. 

Comparing the Efficacy and Safety of Levetiracetam Versus Phenytoin for Treating the Acute Phase of Neonatal Seizures

  Objectives Neonatal seizure is a significant problem in this life course, and its timely and effective treatment is crucial. In this study, we compared the efficacy of levetiracetam versus phenytoin for treating the acute phase of neonatal seizures. Materials & Methods In this single-blind case-control study, 60 consecutive children with neonatal seizures referred to the Children’s medical center in Tehran, Iran, in 2018 were studied. Those neonates who had at least 30 minutes of seizure after Phenobarbital treatment were assigned to receive either phenytoin (20 mg/kg) or levetiracetam (initial dose of 40-60 mg/kg) through block randomization. The efficacy and safety of the two drugs were compared between the groups. Results The response rate was 83.3% and 86.7% in phenytoin and Levetiracetam groups, respectively, which was not significantly different between groups (P=1.000). Adverse effects were nearly similar between groups (6.7% in the phenytoin group and 3.3% in the Levetiracetam group, P=1.000). ConclusionLevetiracetam and phenytoin are both practical and safe for treatingneonatal seizures

Retention and mortality outcomes from a community-supported public–private HIV treatment programme in Myanmar

Introduction: There is a growing interest in the potential contribution the private sector can make towards increasing access to antiretroviral therapy (ART) in low- and middle-income settings. This article describes a public–private partnership that was developed to expand HIV care capacity in Yangon, Myanmar. The partnership was between private sector general practitioners (GPs) and a community-based non-governmental organization (International HIV/AIDS Alliance). Methods: Retrospective analysis of 2119 patient records dating from March 2009 to April 2015 was conducted. Outcomes assessed were immunological response, loss to follow-up, all-cause mortality, and alive and retained in care. Follow-up time was calculated from the date of registration to the date of death, loss to follow-up, transfer out, or if still alive and known to be in care, until April 2015. Cox proportional hazards model was used to identify predictors of loss to follow-up and mortality. Kaplan–Meier survival analysis was used to estimate survival function of being alive and retained in care. Results: The median number of patients for each of the 16 GPs was 42 (interquartile range (IQR): 25–227), and the median follow-up period was 13 months. The median patient age was 35 years (IQR: 30–41); 56.6% were men, 62 and 11.8% were in WHO Stage III and Stage IV at registration, respectively; median CD4 count at registration was 177 cells/mm3; and 90.7% were on ART in April 2015. The median CD4 count at registration increased from 122 cells/mm3 in 2009 to 194 cells/mm3 in 2014. Among patients on ART, CD4 counts increased from a median of 187 cells/mm3 at registration to 436 cells/mm3 at 36 months. The median time to initiation of ART among eligible patients was 29 days, with 93.8% of eligible patients being initiated on ART within 90 days. Overall, 3.3% patients were lost to follow-up, 4.2% transferred out to other health facilities, and 8.3% died during the follow-up period. Crude mortality rate was 48.6/1000 person-years; 42% (n=74) of deaths occurred during the pre-ART period and 39.8% (n=70) occurred during the first six months of ART. Of those who died during the pre-ART period, 94.5% were eligible for ART. In multivariate regression, baseline CD4 count and ART status were independent predictors of mortality, whereas ART status, younger age and patient volumes per provider were predictors of loss to follow-up. Probability of being alive and retained in care at six months was 96.8% among those on ART, 38.5% among pre-ART but eligible patients, and 20.0% among ART-ineligible patients. Conclusions: Effectively supported private sector GPs successfully administered and monitored ART in Myanmar, suggesting that community-supported private sector partnerships can contribute to expansion of HIV treatment and care capacity. To further improve patient outcomes, early testing and initiation of ART, combined with close clinical monitoring and support during the initial periods of enrolling in treatment and care, are required

A Comparative Study of EEG and aEEG in Seizure Diagnosis in Infants Admitted to the NICU

ObjectivesSeizure is a common sign in neonates hospitalized in the neonatal intensive care units (NICU) that may lead to morbidity and mortality. Most neonatal seizures are subclinical. Conventional EEG (cEEG) is the gold standard for detecting and monitoring seizures but is not widely available. Amplitude-integrated electroencephalography (aEEG) has been used for over a decade to evaluate infants with seizures. In this study, we tried to determine the efficacy of aEEG asa widely available diagnostic tool in diagnosing seizures.Materials & MethodsAll cases with seizures or suspicious seizures were admitted to the NICU of the Children’s Medical Center for one year. cEEG and aEEG were performed for these infants. aEEG was recorded for at least six hours with a description of the tracing. Clinical information, outcomes, and questionnaires (patient information) were recorded in detail. The obtained data were analyzed with the SPSS version 24 software.ResultsEleven out of twenty-five aEEG recordings were abnormal; other patients showed normal aEEGs. The most common clinical and neurological manifestations were seizure (68%) and hypotonia (28%); the mortality rate was 12%. No significant correlation was observed between aEEG findings and gender, age, familial relation, outcome, ultrasound result, type of seizure, and underlying disease

Evaluation of Cerebrospinal Fluid and Plasma Amino Acids Levels in Neonates with Refractory Seizures: A Prospective Cohort Study

Background: Altered concentrations of cerebrospinal fluid (CSF) and blood amino acids may be related to epilepsy or the severity of the seizure. In the present study, we assessed the concentrations of amino acids in CSF and plasma in neonates with refractory seizures. Methods: In this prospective cohort study, 27 neonates aged 1 to 56 days with refractory seizures were included. Blood and CSF samples were collected from each neonate within 24 hours after receiving 2nd antiseizure medications. All plasma and CSF samples were sent to the laboratory to measure amino acid concentrations. The associations between CSF and plasma amino acid levels with different variables were evaluated. Results: Except for leucine (P=0.15) and isoleucine (P=0.07), the levels of all amino acids were significantly higher in plasma than CSF. Significant associations were observed between types of seizure and plasma citrulline (P=0.008) and leucine concentrations (P=0.04). The mean of CSF glutamic acid was also statistically different among neonates with different EEG results (P=0.02). Conclusion: Our findings indicate that several plasma and CSF amino acids could be candidate biomarkers for neonatal refractory seizures. Further studies with larger sample size are to confirm our findings