Shortening day length: a potential risk factor for perinatal depression

The aim of this secondary analysis was to determine whether seasonal light exposure, categorized by type of day length, is associated with or predictive of depressive symptoms in late pregnancy and the first 3 months postpartum. Women (n?=?279) expecting their first child were recruited from prenatal clinics and childbirth education classes. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. Day lengths were categorized into short, lengthening, long and shortening. Data analysis included linear mixed models and multiple linear regression. When days were shortening (August to first 4 days of November) in late third trimester, depressive symptom scores were highest (35%) and continued to be higher at each postpartum assessment compared to other day length categories. Implications for clinical practice include increased vigilance for depressive symptoms, particularly if late pregnancy and birth occurs during the 3 months around the Autumn equinox when day length is shortening. Strategies that increase light exposure in late pregnancy and postpartum should also be considered.     

Limb length discrepancy after total knee arthroplasty: A systematic review and meta-analysis

BACKGROUNDLimb length discrepancy (LLD) after total knee arthroplasty (TKA) has been considered as one of the reasons for the unsatisfactory outcome. However, there is no consensus about the extent of LLD that can be considered as clinically relevant.AIMTo evaluate the incidence of radiographic LLD and its impact on functional outcome following TKA.METHODSAll randomized-controlled trial and observational studies on LLD in TKA, published till 22^nd June 2020, were systematically searched and reviewed. The primary outcome was “limb lengthening or LLD after TKA”. The secondary outcomes included “assessment of LLD in varus/valgus deformity” and “impact of LLD on the functional outcome”. RESULTSOf 45 retrieved studies, qualitative and quantitative assessment of data was performed from eight studies and six studies, respectively. Five studies (n = 1551) reported the average limb lengthening of 5.98 mm. The LLD after TKA was ranging from 0.4 ± 10 mm to 15.3 ± 2.88 mm. The incidence of postoperative radiographic LLD was reported in 44% to 83.3% of patients. There was no difference in the preoperative and postoperative LLD (MD -1.23; 95%CI: -3.72, 1.27; P = 0.34). Pooled data of two studies (n = 219) revealed significant limb lengthening in valgus deformity than varus (MD -2.69; 95%CI: -5.11, 0.27; P = 0.03). The pooled data of three studies (n = 611) showed significantly worse functional outcome in patients with LLD of ≥ 10 mm compared to < 10 mm (standard MD 0.58; 95%CI: 0.06, 1.10; P = 0.03). CONCLUSIONLimb lengthening after TKA is common, and it is significantly more in valgus than varus deformity. Significant LLD (≥ 10 mm) is associated with suboptimal functional outcome.     

Inadequate blood volume collected for culture: a survey of health care professionals

Adequate blood culture volume is the single most important determinant for yield of organisms. We sought to determine whether health care professionals are aware of the current evidence-based recommendations for blood culture collection. An anonymous survey of employees qualified to collect blood cultures was conducted (July-October 2004) in an urban tertiary care facility. The survey asked,"What volume of blood should be collected in one bottle for a blood culture?" Of the 360 employees of the hospital surveyed, 355 returned evaluable answers for blood culture volume collected. Overall, 79% (95% confidence interval [CI], 74%-83%) answered less than 10 mL, and 44% (95% CI, 39%-49%) answered less than 5 mL of blood. When examined by occupation, 90% (95% CI, 86%-94%) of nurses, 97% (95% CI, 91%-100%) of technicians, and 55% (95% CI, 46%-64%) of physicians answered less than 10 mL; 52% (95% CI, 45%-59%) of nurses, 63% (95% CI, 46%-79%) of technicians, and 26% (95% CI, 18%-35%) of physicians answered less than 5 mL. Of all respondents, 21% (95% CI, 17%-25%) answered 1 mL or less. Our findings reveal that a high percentage of health care personnel do not know the optimal volume of blood recommended for collection. Because volume remains the most important determinant for the optimal yield of organisms, these findings raise an important quality assurance issue.     

Efficacy and safety of a new power toothbrush in a population with mild to moderate gingivitis

OBJECTIVE: To evaluate the efficacy and safety of a novel ultrasound power toothbrush over a 30-day period in a population with mild to moderate gingivitis. METHODOLOGY: A 30-day, randomized, examiner-blind, parallel-arm study was conducted to evaluate the safety and efficacy of a ultrasound novel power toothbrush (Ultreo - ULT) as compared to a control manual toothbrush (Oral-B 35-MTB). Fifty-three subjects (n = 26 ULT, n = 27 MTB) with a minimum of 18 natural teeth and a L?e and Silness Gingival Index of > or = 1.5 were enrolled. An intraoral examination (oral soft and hard tissues, restorations) was performed, and L?e and Silness Gingival Index scores were recorded at baseline and 30 days. Subjects were instructed to brush at home twice per day with their assigned toothbrush and study toothpaste. A product evaluation questionnaire was also completed at the 30-day study visit. RESULTS: Oral examinations indicated normal findings at all time points for both groups, and no adverse events were reported during the study. There were no significant differences in gingivitis scores at baseline between the toothbrush groups (p > 0.05). From baseline, each treatment group demonstrated a significant reduction in gingivitis over the 30-day period (p < 0.001). However, subjects in the ULT group demonstrated a significantly greater reduction in gingivitis compared to those using the manual toothbrush (p = 0.010). Results from the questionnaire, on average, indicated subjects in the ULT group scored their device higher with respect to the clean feeling after brushing and perceived improvements in gingival health. CONCLUSION: The novel Ultreo ultrasound power toothbrush significantly reduced gingivitis over the 30-day study, and resulted in a significantly greater reduction in gingivitis than a manual toothbrush. No adverse events or safety concerns were identified with either the power or manual toothbrush.     

Epidemiology of dental caries in Chandigarh school children and trends over the last 25 years

The prevalence of dental caries in 6, 9, 12 and 15-year-old school children of Chandigarh, selected on a randomized basis was evaluated using Moller's criteria (1966) and correlated with the various risk factors. The mean deft was found to be 4.0 +/- 3.6 in 6 year old and 4.61 +/- 3.14 in 9 year old, whereas the mean DMFT in 12 and 15 year old was found to be 3.03 +/- 2.52 and 3.82 +/- 2.85 respectively. The high prevalence of dental caries in these children was attributed to the lack of use of fluoride toothpaste (80% children), lack of knowledge about etiology of dental caries (98%) and frequency of sugar exposures up to more than five times per day (30%).     

Comparing safety margin of innervation points of the subscapular nerves from the base and tip of the coracoid process

Introduction

Arthroscopic procedures like repair of subscapularis tendon tears pose a potential risk of injury to subscapular nerves. Damage to these nerves can be minimized by knowledge of relationship of subscapular nerve with nearby bony landmark such as coracoid process.