Diagnostic evaluation of optical coherence tomography parameters in normal, preperimetric and perimetric glaucoma patients

AIM: To compare the diagnostic ability of glaucoma parameters measured by the optical coherence tomography (OCT) in normal, preperimetric glaucoma (PPG) and perimetric glaucoma (PG) patients. METHODS: This cross-sectional observational study includes 127 eyes of 127 subjects. Patients were divided into PPG (51 eyes), PG (46 eyes), and normal controls (30 eyes) based on clinical optic disc assessment and Humphrey visual field changes. The Heidelberg Spectralis OCT machine using Glaucoma Module Premium Edition software was used to measure the retinal nerve fiber layer (RNFL) and Bruch’s membrane opening-minimum rim width (BMO-MRW) to assess the optic nerve head and ganglion cell layer (GCL) thickness in the macula. RESULTS: RNFL, MRW, and GCL thickness were all significantly thinner in PG compared to PPG and the normal group. The BMO-MRW parameters showed better specificity (>70%) at 90% specificity compared to both RNFL and GCL parameters to discriminate normal, PPG, and PG patients. All BMO-MRW parameters showed higher area under curves (AUC) compared to RNFL and GCL parameters with the highest AUC observed in the superotemporal sector of the BMO-MRW (AUC=0.819 and and 0.897 between normal and PPG and PG groups respectively). CONCLUSION: While the BMO-MRW best discriminates PPG and PG against normal eyes, GCL parameters poorly differentiate the three groups.     

The effect of immediate postpartum levonorgestrel contraceptive implant use on breastfeeding and infant growth: a randomized controlled trial

Objective

This study assessed whether immediate postpartum insertion of levonorgestrel contraceptive implants is associated with a difference in infant growth from birth to 6 months, onset of lactogenesis, or breastfeeding continuation at 3 and 6 months postpartum compared to delayed insertion at 6 to 8 weeks postpartum.

The relationship between habit and healthcare professional behaviour in clinical practice: a systematic review and meta-analysis

Theories of behaviour used to understand healthcare professional behaviour often focus on the deliberative processes that drive their behaviour; however, less is known about the role that implicit processes such as habit have on healthcare professional behaviour. This systematic review aimed to critically appraise and synthesise research evidence investigating the association between habit and healthcare professional behaviour. A search of five databases (PsycINFO, EMBASE, Scopus and CINAHL) was conducted up until 29 February 2016 to identify studies reporting correlations between habit and healthcare professional behaviours. Meta-analyses were conducted to assess the overall habit-behaviour association across all behaviours. A subgroup analysis assessed whether the habit-behaviour relationship differed depending on whether the behaviour was objectively measured or assessed by self-report. We identified nine eligible studies involving 1975 healthcare professionals that included 28 habit-behaviour correlations. A combined mean r₊ of 0.35 (medium effect) was observed between habit and healthcare professional behaviour. The habit-behaviour correlation was not affected by whether behaviour was measured objectively or by self-report. This review suggests that habit plays a significant role in healthcare professional behaviour. Findings may have implications for considering health professionals’ habit when promoting the provision of evidence-based health care, and for breaking existing habit when de-implementing outdated, non-evidence-based practices.     

Multiple developmental dental anomalies and hypermobility type Ehlers-Danlos syndrome

Concurrent existence of multiple developmental dental anomalies: hypodontia of permanent mandibular incisors, dentin dysplasia, transmigration, root dilaceration, ectopic eruption and delayed eruption combined with systemic abnormalities including joint hyperlaxity and skin hyperextensibility aided in diagnosis of a sporadic case of hypermobility type of Ehlers-Danlos syndrome in a Jordanian Arab male. In dental practice the presence of multiple developmental dental anomalies expressing simultaneous defects in different stages of tooth development should raise suspicion of possible of manifestation of an underlying systemic abnormality.     

Tooth-size discrepancy and Bolton's ratios: a literature review

OBJECTIVES: To review the literature on Bolton's tooth-size discrepancies (TSD) with specific attention to the prevalence of TSD, and the possible influence of different classes of malocclusion, gender and racial group. Also examined were the validity of the standard deviations from Bolton's samples as an indicator of significant TSD, methods of measurement of TSD and their reproducibility. Based on the review, suggestions are made as to how future work could be improved. RESULTS AND CONCLUSIONS: Studies have reported from 20 to 30% of people with significant tooth-size anterior discrepancies and 5-14% for overall TSD. Bolton's original sample was appropriate for indicating what ratio is most likely to be associated with an excellent occlusion, but was not suited to indicating the size or prevalence of significant TSD. Most studies use samples that are not likely to be representative of orthodontic patients in the UK or, indeed, elsewhere. Although some statistically significant differences have been reported, gender and racial group seem unlikely to have a clinically significant influence on Bolton's tooth-size ratios. Class III malocclusions may have larger average ratios. Computerized methods of measurement are significantly more rapid. Most studies performed or reported their error analysis poorly, obscuring the clinical usefulness of the results. Studies are needed to properly explore the reproducibility of measurement of TSD and to appropriately determine what magnitude of TSD is of clinical significance.     

Amhezole,A Novel Fungal Secondary Metabolite from Aspergillus terreus for Treatment of Microbial Mouth Infection

Bio‐guided fractionation of Aspergillus terreus extract leads to isolation of a novel terpenoidal secondary metabolite. The isolated compound and the total alcoholic extract of Aspergillus terreus showed a remarkable activity against microbial mouth infections; namely, Candida albicans, Lactobacillus acidophilus, Streptococcus gordonii, and S. mutan. Moreover, the Minimum Inhibitory Concentration of the isolated compound was determined and showed low values. The combination of each of the alcoholic extract of A. terreus and the isolated compound Coe‐Comfort tissue conditioner inhibited the growth of Candida albicans at concentrations of 500 and 7.81 µg/mL, respectively, Lactobacillus acidophilus at concentrations of 250 and 7.81 µg/mL, respectively, Streptococcus gordonii at concentrations of 1000 and 62.50 µg/mL, respectively, and S. mutans at concentrations of 1000 and 125 µg/mL, respectively. The oral dosing of the extract and the isolated compound did not show any significant effect on the activity of alanine aminotransferase, aspirate aminotransferase, and the levels of blood urea and serum creatinine. Copyright © 2017 John Wiley & Sons, Ltd.     

Synthesis and functionalization of chitosan built hydrogel with induced hydrophilicity for extended release of sparingly soluble drugs

Addressing the functional biomaterials as next-generation therapeutics, chitosan and alginic acid were copolymerized in the form of chemically crosslinked interpenetrating networks (IPNs). The native hydrogel was functionalized via carbodiimide (EDC), catalyzed coupling of soft ligand (1,2-Ethylenediamine) and hard ligand (4-aminophenol) to replace –OH groups in alginic acid units for extended hydrogel- interfaces with the aqueous and sparingly soluble drug solutions. The chemical structure, Lower solution critical temperature (LCST ≈ 37.88 °C), particle size (Z_h,app ≈ 150–200 nm), grain size (160–360 nm), surface roughness (85–250 nm), conductivity (37–74 mv) and zeta potential (16–32 mv) of native and functionalized hydrogel were investigated by using FT-IR, solid state-¹³C-NMR, TGA, DSC, FESEM, AFM and dynamic light scattering (DLS) measurements. The effective swelling, drug loading (47–78%) and drug release (53–86%) profiles were adjusted based on selective functionalization of hydrophobic IPNs due to electrostatic complexation and extended interactions of hydrophilic ligands with the aqueous and drug solutions. Drug release from the hydrogel matrices with diffusion coefficient n ≈ 0.7 was established by Non- Fickian diffusion mechanism. In vitro degradation trials of the hydrogel with a 20% loss of wet mass in simulated gastric fluid (SGF) and 38% loss of wet mass in simulated intestinal fluid (SIF), were investigated for 400 h through bulk erosion. Consequently, a slower rate of drug loading and release was observed for native hydrogel, due to stronger H-bonding, interlocking and entanglement within the IPNs, which was finely tuned and extended by the induced hydrophilic and functional ligands. In the light of induced hydrophilicity, such functional hydrogel could be highly attractive for extended release of sparingly soluble drugs.