Hepatitis C Virus (HCV) infection is usually treated with direct acting antivirals (DAAs) for 12 weeks. In treatment naive patients with genotype (GT) 1 infection without cirrhosis and baseline viral load < 6 million, 8 weeks of Ledipasvir/Sofosbuvir (LDV/SOF) is an option. Eight weeks with Glecaprevir/Pibrentasvir (GLE/PIB) is an option for patients with GT 1 through 6 without cirrhosis. Our objective was to evaluate achievement of Sustained Virologic Response (SVR) after 8 weeks of LDV/SOF or GLE/PIB in our HCV-infected veterans. Patients with HCV infection that received GLE/PIB or LDV/SOF for a planned 8 weeks of therapy in the past four years were reviewed (January 2015-September 2018). Treatment outcomes were evaluated through medical record review. Two hundred sixty-five veterans were initiated on 8 weeks of therapy with either GLE/PIB or LDV/SOF. Of these, 231 (87%) were initiated on 8 weeks of LDV/SOF and 34 (13%) were initiated on 8 weeks of GLE/PIB. The majority of patients had GT 1 (93%) infection. One hundred and ninety-five veterans who completed 8 weeks of LDV/SOF and 30 veterans on GLE/PIB had follow-up viral loads. The overall SVR was 95%. Treatment with GLE/PIB resulted in a higher SVR rate (100%) compared to LDV/SOF (95%). Elderly patients had similar SVR rates. Treatment with 8 weeks of DAA is effective in our veteran population and showed an SVR rate similar to literature reports. The SVR for patients treated with 8 weeks LDV/SOF was slightly lower than the SVR for GLE/PIB; however, the GLE/PIB population was smaller

Background: Intensive care patients are often in need of sedation to endure being intubated. Light sedation is increasingly common since it has been proved to offer benefits such as faster recovery to patients. Aim: The aim of this study was to describe critical care nurses’ experiences of nursing patients lightly sedated with dexmedetomidine. Research Methodology: Qualitative personal interviews were conducted during 2015 with 10 critical care nurses in Sweden. Interview transcripts were analysed using inductive qualitative thematic analysis. Results: Light sedation of the patient facilitated communication and interaction with him or her, and the relationship between the patient and his or her family members. Dexmedetomidine was described as a fairly new drug, and the critical care nurses stated that they needed more knowledge about it and about sedation scales in order to learn more about the drug’s mechanism of action and its potential side effects on patients. Conclusion: It is important to critical care nurses to learn more about dexmedetomidine and about sedation scales to assess levels of sedation, as light sedation has been shown to benefit the patient as opposed to deep sedation that can increase recovery time.

Background: Asthma is the most common chronic respiratory disorder in childhood. Asthmatic attacks are described and classified according to the type of wheezing to Non –atopic and Atopic asthma (IgE mediated wheezing). The aim of this review is to determine the onset of clinical diagnosis in relation to clinical presentation of asthma in children and obstacles related to delay of Asthma diagnosis. Methods: This review highlights the results of studies done regarding clinical diagnosis in relation to clinical presentation and of asthma in children. An extensive search has been conducted for researches about asthma in children. This search based on the publications posted on the National Center for Biotechnology Information PubMed or by Google Scholar. Key words used for the research: Asthma, clinical diagnosis, children. Results and Conclusion: Diagnosing asthma in young children is difficult because children often cough and wheeze with colds and chest infections, but this is not necessarily asthma. Miss diagnosis of asthma in children occurs when physicians diagnose patients with asthma from the clinical diagnosis in the first attack without excluding other asthma mimickers which can be any other respiratory problem. There is over-diagnosis of asthma due to the symptoms which mimic other respiratory infections. First episodes of cough, runny nose and fever that happen in cold/flu season- fall/winter/early spring is likely not asthma. If the child has several more episodes of wheeze and cough, it is likely to be asthma. Since there is no diagnostic test available for children younger than 6 years of age, making a diagnosis in this age group is more difficult than in older children. Over the age of about 6 years it is possible for a child to have a spirometer test

Airway hyperresponsiveness (AHR) is a hallmark of persistent asthma measured using direct or indirect airway bronchial challenge testing. The purpose of this study is to investigate the putative relationships between type 2 inflammatory biomarkers, airway geometry (FEV1 and FEF25-75) and specific IgE (RAST or skin prick) to AHR. We performed a retrospective analysis of our database (n = 131) of patients with asthma. Of these subjects, 75 had a histamine challenge and 56 had a mannitol challenge. Fractional exhaled nitric oxide (FeNO) and specific immunoglobulin E (IgE) but not blood eosinophils were significantly higher in patients with AHR to either histamine or mannitol. FEV1 % and FEF25 - 75 % were significantly lower in patients with AHR. Elevated Type 2 biomarkers including FeNO and specific IgE but not blood eosinophils were associated with AHR. Highlights: FeNO and specific IgE but not blood eosinophils are raised in patients with airway hyperresponsiveness.

Background: Chronic rhinosinusitis (CRS) is a heterogeneous and multifactorial inflammatory disease of the nasal and paranasal mucosa. To date, no internationally standardized uniform classification has been developed for this disease. Usually, a phenotype classification according to CRS with (CRSwNP) and without (CRSsNP) polyposis is performed. However, through a variety of studies, it has been shown that even within these phenotypes, different endotypes of CRS exist, each with a different underlying inflammatory pathophysiology. In this mini-review, we aim to outline the essential immunological processes in CRSwNP and to highlight the modern therapeutic options with biologics derived from this disease. Methods: Current knowledge on the immunological and molecular processes of CRS, especially CRSwNP, was compiled by means of a structured literature review. Medline, PubMed, national/international trial and guideline registries as well as the Cochrane Library were all searched. Results: Based on the current literature, the different immunological processes involved in CRS and nasal polyps were elaborated. Current studies on the therapy of eosinophilic diseases such as asthma and polyposis are presented and their results discussed. Conclusion: Understanding the immunological basis of CRSwNP may help to develop new personalized therapeutic approaches using biologics. Currently, 2 biologics (dupilumab, omalizumab) have been approved for the therapy of CRSwNP (polyposis nasi) in Europe.

Background: Premarital sexual practice significantly attributes for increase adolescent’s risk of unintended pregnancy, early marriage, abortion and STIs. In Ethiopia adolescents were intended to engage at early initiation to sexual intercourse without having proper protection has been one of the concerns. Study aimed to assess the prevalence of premarital sexual practice and associated factors among high school students. Method: A facilities based study design was employed. Data were collected from 291 randomly selected Negade and Finca Bamo high school students using structured questionnaire from June 1-30, 2018. Bi-variate logistic regression used to identify variables that crudely associated and variables with p - value < = 0.05 fitted to multiple logistic regression. Odds ratio with 95% confidence interval was estimated using multivariable logistic regression to identify independent predictors of premarital sex. Result: Among high school students, 31.2% reported had experienced premarital sexual practices. This shows that premarital sexual practices among high school adolescent’s students were high. Drinking alcohol [AOR = 4.06, 95%CI, (2.06 - 7.99)]. Watching pornographic video [AOR: 2.78, 95%CI, (1.45 - 5.3)] and educational status of mothers [AOR: 0.33; 95% CI (0.13, -0.84)] were significantly associated factors. Conclusion: Drinking alcohol, watching pornography and mother education were predominantly significantly associated. Therefore, an integrated effort needs to be highlighted to deter the health behavioral problems of school adolescents at the early stages. 

A 60-year-old woman had central retinal artery occlusion (CRAO) presented to the ophthalmology department with a sudden, painless loss of vision. Her initial visual acuity was light perception and she treated with hyperbaric oxygen therapy (HBOT) 4 hours after the development of visual symptoms. Systemic risk factors were not found so she was diagnosed as having idiopathic CRAO. Her vision improved from light perception to 20/50 after the HBOT. Any complications such as neovascularization were not developed until the last follow up visit of 8th months.

Anatomical separation of the retinal pigment epithelium from the Bruch membrane is defined as retinal pigment epithelial detachment (PED) andit is classified as drusenoid, serous, and vascularized. Vascularized PED is mostly associated with choroidal neovascularmembrane due to age-related macular degeneration and the risk of vision loss is high in this situation. Studies show that all of baseline values including BCVA, PED height, subretinal fluid, central macular thickness, PED volume, vertical dimension, presence of coincident macular pathology, reflectivity and morphology on optical coherence tomography have prognostic importance. Current treatment protocols mainly based on intravitreal injection of anti-vascular endothelial growth factor (VEGF).Even the bevacizumab was the first anti-VEGF that was used for treatment in PED, there are several reports show the insufficiency of bevacizumab. In treatment-naïve eyes, both of ranibizumab and aflibercepthave similar effect in vascularized PED. In treatment-resistant eyes, high dose bevacizumab or switching therapy of anti-VEGF procedures can be effective when considering of all cases, aflibercept seems more effective than other options.We aimed in this manuscript, to give a general information about different characteristics of PEDs and to investigate the treatment strategies in the light of current literature.

Introduction: Intense Pulsed Light (IPL) is the therapeutic tool implemented in the treatment of dry eye, characterized by the emission of waves of 500-1200nm in the region of the upper and lower eyelids. Dry eye is a recurring complaint in ophthalmology offices and has an impact on the patient’s quality of life. It results from dysfunction of the meibomian glands, duct obstruction, and quantitative and qualitative changes in glandular secretion. It is manifested by dryness and irritation, foreign body sensation, burning, tearing, and eye fatigue. The available treatments are short term palliative with unsatisfactory results.

Background: Corneal abrasions are a common result of eye trauma. Corneal injuries are very common in both the adult and pediatric population and account for a significant proportion of the workload of most emergency departments. Although abrasion heals well with preservative treatment, it still causes pain and job lost. The abrasion result from the scrabble of the corneal epithelium. These injuries cause pain, tearing, lids spasm, light scare, foreign body sensation, decreased visual acuity/blurring, and a gritty feeling. The light, friction & wink was worse the condition. Most abrasion cure within 24-27 hours and seldom proceed to erosion or infection. The study aims to use bandage soft contact lens [BSCL] as a primary treatment for traumatic corneal abrasion [TCA] instead of traditionally use pressure patch [PP]. Patients and methods: The present prospective study has been conducted on 50 patients attending the out-patient department of ophthalmology in an Alyarmouk teaching hospital for six months after taking ethical permission. Before subjecting the patient to the treatment of bandage soft contact lens therapy, a detailed clinical history and thorough local examination have been done. A history indicating the occurrence of recent ocular trauma followed by severe pain, redness, lids spasm, photophobia, and tearing of the involved eye is suggestive of a corneal abrasion. Always we ask about contact lens wear as this can complicate the presence of an abrasion. To confirm the diagnosis of traumatic corneal abrasion we examine the cornea by slit-lamp under cobalt-blue filtered light after the application of tetracaine eye drops & fluorescein strips. The treatment of 50 consecutive patients presenting with traumatic corneal abrasion has been treated with anesthetic eye drop (tetracaine 0.5%) to relieve pain and lids spasm, antibiotic eye drop (ofloxacin 0.3%), therapeutic bandage soft contact lens was applied to provide pain relief and once again act as a splint to promote epithelial healing, then visual acuity was measured by Snellen chart, a cycloplegic eye drop (cyclopentolate 1%) was applied to relieve ciliary spasm & then preservative-free lubricant eye drop were applied lastly. This criterion dramatically relieves most, if not all of the pain the patient may be experiencing (which is a big plus for the patient and earns instantaneous trust), but it also allows the patient to return to work/school or any other daily activities. Patients have been evaluated after 24hours, 72hours and after 1week regarding pain, visual acuity, and complications. Though pressure patch [PP] occasionally advice in abrasion therapy, it does not assist and may prevent recovery. Employ the protective eyewear can preclude the traumatic corneal abrasion. Results: A total of 50 cases were enrolled in our study during the study period of 6 months. Out of 50 patients, there were 30males and 20 females and the male/female ratio was 3:2. The patient’s age was ranged from 5-35years. The commonest cause of injury was direct minor trauma (80% of cases), with cosmetic & optical contact lenses related problems accounting for 20% of presentations, visual acuity was documented correctly in 90% of adult and pediatric group and difficult to documented in children less than 6-year-old 10%. Traumatic corneal abrasion treated with bandage soft contact lens has an apparent advantage over the traditional pressure patch in terms of reduced pain, speedier healing, and an advantage of faster rehabilitation, facilitation epithelial healing, and proper surface hydration. Evaluation of pain revealed sufficient comfort with this regimen, allowing 45 patients (90%) to go back immediately to their occupations. Moreover, visual function is retained without any complication. Healing of the traumatic corneal abrasion occurred within 1 to 3 days in all patients, with minimal or no pain. The infection did not occur at the time of the follow up. We remove the bandage soft contact lens after 1 week to allow epithelial migration and attachment without the interference of the shearing forces of the upper lid. Conclusion: The use of bandage soft contact lens as a primary treatment for a traumatic corneal abrasion is a safe and effective method with anesthetic eye drop (tetracaine 0.5%), antibiotic eye drop (ofloxacin 0. 3%), cycloplegic eye drop (cyclopentolate 1%), preservative-free lubricant drop instead of traditionally pressure patch. Bandage soft contact lens causes dramatic improvement from pain, lid spasm, tearing & visual function is retained without any complication, and patients can immediately resume their regular activities.

tRNA-dependent amidotransferases (AdT) are essential enzymes for protein biosynthesis in many bacteria and in all archaea. As AdT is essential for a number of pathogenic bacteria, and it is absent from mammalian cytoplasm, it is considered as a putative target for novel inhibitors that could be lead compounds to develop a new class of antibiotics. Besides GatFAB of Saccharomyces cerevisiae mitochondria and GatAB of Plasmodium falciparum apicoplast, all reported AdT can be divided into two groups: heterodimeric GatDE and heterotrimeric GatCAB. The latter is required to catalyze the conversion of Glu-tRNAGln and/or Asp-tRNAAsn into Gln-tRNAGln and/or Asn-tRNAAsn in many pathogenic bacteria. Recently determined high resolution crystal structures of several GatCAB could be used to design new inhibitors. In this review, we highlight the essential role of AdT for the faithful translation of glutamine and/or asparagine codons, we describe important features of the crystal structures of several GatCAB as well as tRNA/AdT/aaRS complexes for the formation of Gln-tRNAAsn and Asn-tRNAAsn, we finally summarize discoveries of AdT inhibitors based on their analogy to glutamine, adesosine tripoliphosphate and 3’-end of tRNA.

Background: The present study was conducted to study the donor profile and to assess the trends of cornea donation. Methodology: This was conducted as a hospital based cross sectional study at a tertiary care centre in Central India for a period of 5 years. Data was retrieved from 70 patients from eye bank who filled form of eye donation at Eye bank of our institution. Sociodemographic profile of donors, cause of death and time since death was recorded. Source of information regarding corneal donation and reason for not willing to donate the cornea for research purpose was recorded from the filled form. Further cornea enucleated were subjected to serology and their utilization for various purposes were recorded in questionnaire. Results: The present study retrieved data from a total of 70 donor forms with mean age of 65.84 ± 18.4 years. Cornea obtained from younger patients were mainly utilized for corneal transplantation whereas that from elderly age group > 60 years were mainly utilized for research/training purpose and the observed difference was statistically significant (p < 0.01). The corneas retrieved and utilized immediately after death were significantly used for optical or therapeutic purposes (p < 0.05). Conclusion: The present highlights the donor profile and trends of corneal donation at the tertiary care facility of Central India. It was observed that though the younger population and older population both are aware regarding corneal donation but still they are less aware on purpose for which cornea can be utilized. Quality of donor cornea is better when death to enucleation time interval was less.

Background: A cracked tooth may be challenging for dentists because it may present with varied intensities, may be asymptomatic, and may still not be clinically visible. The transilumination method can facilitate diagnosis and ensure appropriate treatment in such cases. The aim of the present article was to report a clinical case of an anterior cracked tooth with a nonesthetic class IV restoration. Clinical considerations: A 22-year-old male patient with chief complaint of esthetics of upper front tooth reported a history of dental trauma. Transilumination with a dental curing light unit was used to examine the region. The tooth 11 was diagnosed with several cracks and a nonesthetic class IV restoration. For repair, the universal adhesive system Scotchbond Universal was applied without previous acid etching, followed by the application of Filtek Z350 of color type B2 (for body) above the old restoration, taking care to slightly overlap the fracture line with the composite and to not extend the composite until the incisal margin. Subsequently, a thin layer of Filtek Z350 of color type B2 (for enamel) was applied over the bevel until the incisal margin, and the tooth shape was carved. Conclusion: This case report demonstrates simplified diagnosis of an anterior cracked tooth with transilumination; following repair, the esthetic quality of the restoration was considered satisfactory and approved by the patient.

Functional appliances used in correction of class II malocclusions are shown to modify the neuromuscular environment of dentition & associated bones. There are many studies related to the skeletal, dental and neuromuscular changes which are evaluated cephalometrically, clinically as well as with the recent diagnostic aids like MRI. The aim of this short communication was to highlight and discuss the different aspects of condylar modifications and its role in its growth. The Twin Block has higher effectiveness & comfort as compared to other removable functional appliances [1.2]. The action of Twin Block & Bionator is for 24 hours so effects are more with these appliances. Over the years, several theories have emerged attempting to shed light on condylar growth. One of the earliest theories, the genetic theory, suggests the condyle is under strong genetic control like an epiphysis that causes the entire mandible to grow downward and forward. Although this may be related more to development of the prenatal than postnatal condyle, the theory does indirectly question the effectiveness of orthopedic appliances in condylar growth as proposed by Brodie [3,4]. Several long-term investigations actually showed clinically insignificant condylar growth modification after continuous mandibular advancement with a reasonable retention period in human beings although the initial treatment results appeared encouraging. This leads to the conclusion that the general growth of the condyle appears relatively unalterable in long-term studies. A second hypothesis based on the earliest available acute and blind EMG monitoring technique, suggests that hyperactivity of the lateral pterygoid muscles (LPM) promotes condylar growth. Rees reported that other muscles and tendons, including those of the deep masseter and temporalis, also attach to the articular disk region. Attachments of the LPM to the condylar head or articular disk may be expected to cause condylar growth, but anatomic research has not found evidence that significant attachments actually exist [5,6]. The LPM tendon is observed attaching, however, to the anterior border of the fibrous capsule that in turn attaches to the fibrocartilage of the condylar head and neck anteriorly. At the same time, it is doubtful that initial hyperactivity could occur where the LPM muscle has been shortened by continuous mandibular displacement therapy. By using LPM myectomy in rats, which may have disrupted condylar blood supply, Whetten and Johnston found little evidence that LPM traction had any pronounced effect on condylar growth. More recently, permanently implanted longitudinal muscle monitoring techniques have found that the condylar growth is actually related to decrease postural and functional LPM activity. This notion was also supported in human studies by Auf der Maur, Pancherz and Anehus- Pancherz, and Ingervall and Bitsanis that reported decreased muscle activity. The LPM hyperactivity theory brought forward by Charlier et al. Petrovic, and later espoused by McNamara however, was important in prompting further investigations in muscle-bone interactions [7,8]. A third hypothesis, the functional matrix theory, postulates the principal control of bone growth is not the bone itself, but rather the growth of soft tissues directly associated with it. Although this was supported in part by investigations testing the different growth and developmental responses between the condyle and epiphysis, there has been no explanation as to exactly how condylar growth would be stimulated. Thus, this theory’s validity has been questioned. One of the reasons was that there was little explanation of the specific mechanism by which the condyle was stimulated to grow. Endow and Hans presented an excellent overall perspective suggesting that mandibular growth is a composite of regional forces and functional agents of growth control that interact in response to specific extra-condylar activating signals [9,10].

Today, there is a considerable increase in localizing adrenal bulks with the bringing radiologic diagnosis methods having high technology into use and improvement in diagnostic tests. Adrenal glands are vital tissues for the organism due to the hormones they secrete. Death is a natural result in the absence of adrenal cortex. Adrenal bulks can be seen with different clinical, laboratory and radiological data. These bulks are often benign and rarely malign. They can be functional or non-functional. Major treatment methods used fort he treatment of adrenal gland primary tumors or metastases are surgery, arterial embolisation, chemical ablation, radiofrequency ablation and radiotherapy [1-4]. Adrenal glands are one of the metastatic fields. In wide autopsy series, adrenal metastasis has been determined between the rates of 13-17% [5]. While unilateral metastasis is common, bilateral metastasis’ rate of incidence is between 4-20%. It has been stated that lung (35%), gastric (14%), esophageal (12%) and hepatobiliary (10%) primary carcinomas adrenal metastasis are prevalent most frequently [2]. Curative treatments are tested on patients having cancer with oligo metastasis limited with adrenal gland and primary source is under control because of the expectation of long-term survival, and the surgery is the first choice. These bulks can be treated with open and laparoscopic surrenalectomy in a curative way. It was reported in studies that overall survival was longer in resection of clinically isolated adrenal metastases when compared with nonsurgical therapy (including RFA, external beam radiotherapy, arterial embolization, radioembolization, chemical ablation, and cryoablation) [1,2,5,7]. Lo et al., found one-year survival as 73% and two-year survival as 40% in their study conducted on 52 patients having curative resection for solitary adrenal metastasis [3]. Tanvetyanon et al., demonstrated 5-year survival rates of 25% following resection of isolated synchronous adrenal metastases and reported 26% after resection of metachronous adrenal metastases in their study conducted on NSCLC patients developing solitary adrenal metastasis [4]. Conducted studies revealed that the rate of complication was 9-20% in patients having adrenalectomy for solitary adrenal metastasis [2-4,7]. In recent years, the use of radiotherapy, which is a treatment modality as effective as surgical resection, has become prevalent for the management of oligometastases. Today, three different modalities have been tested in the radiotherapy treatment of adrenal gland metastases. In the first one, total 50 Gy treatment dose with 3D-CRT as daily 2 Gy fraction dose is given [8]. The second one is IMRT implementations for adrenal gland metastases but it isn’t thought as suitable according to Practice Guidelines for Neuroendocrine Tumors published by NCCN in 2010. The third radiotherapy modality is stereotactic body radiotherapy (SBRT). SBRT implementations have started to be preferred today since they are completed in a few fractions in addition to that they show close results to surgery for primary tumors and metastases. Holy et al., implemented SBRT to patients having 13 solitary adrenal metastases with NSCLC at 5 fractions and between 20 and 40 Gy total doses. They found disease-free survival as median 12 months, overall survival as median 23 months and local control rate as 77% [9]. In SBRT implementations for different cancer types determined 30 adrenal metastases, Chawla et al., reported the rates of one-year survival, local control and distant metastasis as 44%, 55% and 13% respectively [10]. In Casamassima et al.,’s study on this issue, the rate of two-year local control was found as 90% [11]. Second degree toxicity was seen in none of the above mentioned studies according to the RTOG toxicity classification. Wardak et al., reported that the patient having lung cancer that they implemented SBRT for bilateral adrenal metastases developed adrenal insufficiency depending on SBRT [6]. Ippolito et al., Reported that adrenal insuffiency may be due to both the tumor and the local treatment [12]. Incidence of symptomatic adrenal insufficiency were reported 4% [2,13]. Casamassima et al and Onishi et al studies, two grade 2 adrenal insuffiencies were reported [11,14]. Consequently, when all these data were evaluated, it is seen that SBRT use has gradually become prevalent for patients not suitable for surgery because of comorbid disease, for patients having oligometastatic cancer that are not suitable for surgery since it has vital risk to resect or that refuse surgery. However, it hasn’t been clear yet that local control will be provided with how many total doses and which fraction schema. There is no agreement on the examination of the adrenal hormone axes because of the short length of life. Besides, it should be kept in mind that adrenal insufficiency can develop in patients implemented SBRT because of bilateral adrenal metastasis developing as synchronous or metachronous. The hormone levels of these patients need to be followed. More researches should be done to lighten this matter.  

Radiation of different wavelengths can kill living organisms, although, the mechanism of interactions differs depending on their energies. Understanding the interaction of radiation with living cells is important to assess their harmful effects and also to identify their therapeutic potential. Temporally, this interaction can be broadly divided in three stages – physical, chemical and biological. While radiation can affect all the important macromolecules of the cells, particularly important is the damage to its genetic material, the DNA. The consequences of irradiation include- DNA damage, mutation, cross-linkages with other molecules, chromosomal aberrations and DNA repair leading to altered gene expression and/or cell death. Mutations in DNA can lead to heritable changes and is important for the induction of cancer. While some of these effects are through direct interaction of radiation with the target, radiation can interact with the surrounding environment to result in its indirect actions. The effects of radiation depend not only on the total dose but also on the dose rate, LET etc. and also on the cell types. However, action of radiation on organisms is not restricted to interactions with irradiated cells, i.e. target cells alone; it also exerts non-targeted effects on neighboring unexposed cells to produce productive responses; this is known as bystander effect. The bystander effects of ionizing radiations are well documented and contribute largely to the relapse of cancer and secondary tumors after radiotherapy. Irradiation of cells with non-ionizing Ultra-Violet light also exhibits bystander responses, but such responses are very distinct from that produced by ionizing radiations.

Fibrous dysplasia is an osteolytic lesion in which bone is replaced by an instable fibrous osseous tissue. The aim of this case report is to highlight dental rehabilitation (bone grafts to allow dental implant) on patients suffering of this condition. A 39-year-old female with a hard-traumatic event in childhood desired a dental implant rehabilitation on her teeth 19 and 30 after an orthodontic alignment. A Cone-Beam Computed Tomography (CBCT) was performed showing a massive radiopaque lesion of the anterior mandible. The bone grafts and dental implants were successfully managed. A non-invasive treatment with regular follow up was chosen for this case. No evolution was noticed twenty-four month later at the follow up CBCT.

Background: Adipose tissue is one of the main sites of energy homeostasis that regulates whole body metabolism with the help of adipokines. Disruption in its proper functioning results in adipose tissue remodeling (primarily hypertrophy and hyperplasia) which directly influences the secretion of said adipokines. Obesity characterized as chronic low-grade inflammation of the adipose tissue is one such condition that has far reaching effects on whole body metabolism. Inflammation in turn results in immune cells infiltrating into the tissue and further promoting adipocyte dysfunction. Purpose: In our study we explored this adipose tissue-innate immunity axis by differentiating adipose tissue derived stem cells (ADSCs) into white and beige adipocytes. We further stimulated our cultures with lipopolysaccharide (LPS), flagellin, or meteorin-like, glial cell differentiation regulator (METRNL) to trigger an inflammatory response. We then evaluated Toll-like receptor (TLR) mRNA expression and secretion of interleukin (IL-6), interleukin-8 (IL-8), brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) in these cultures. Results: We found that TLR2 is the highest expressed receptor in adipocytes. Further, LPS and METRNL are strong activators of TLR2 in white and beigeBMP7(-) adipocytes. TLR4 was not significantly expressed in any of our cultures despite LPS stimulation. TLR9 expression is upregulated in ADSCs upon LPS and METRNL stimulation. IL-6 and IL-8 secretion is increased upon LPS stimulation in white adipocytes. METRNL activates both IL-6 and IL-8 expression in adipocyte cultures. Lastly, BDNF and NGF is secreted by all adipocyte cultures with beigeBMP7(-) and beigeBMP7(+) secreting slightly higher amounts in comparison to white adipocytes. Conclusion: ADSCs and adipocytes alike are capable of expressing TLRs, but white adipocytes remain the highest expressing in both control and stimulated cultures. TLR2 is highly expressed in white and beige adipocytes whereas TLR4 showed no significant expression. LPS and METRNL trigger IL-6 and IL-8 secretion in adipocytes. Products of white adipocyte “browning” are capable of secreting higher amounts of BDNF and NGF in comparison to white adipocytes.

Calcium is the most common element in the tooth’s structure. In addition, calcium is one of the elements that are effective in maintaining dental health. As a result of calcium deficiency, the tooth becomes brittle and begins to rot. Calcium deficiency usually occurs in acidic beverage consumption and during canal treatment. A study was conducted to determine the degree of calcium removal in the root canal dentin after 17% EDTA, 17% EGTA, 15% EDTAC and 1% tetracycline-HCl treatment; later with or without 2.5% NaOCl [1]. Extracted single-rooted human teeth were bisected longitudinally and the root halves (n = 100) were isolated with nail varnish, leaving the root canal exposed. The samples were immersed in the test solutions for 1 and 5 minutes, after which the amount of calcium ion (Ca2+) release into the solutions was determined by flame photometry. The calcium ions (Ca2+) present in hydroxyapatite crystals are one of the main inorganic elements of dentin [2]. It has been reported that some chemicals used for endodontic irrigation are capable of causing alterations in the chemical composition of dentin [3-6]. MethodsDetermination of calcium in the tooth’s structure is very important. Calcium determination, Flame Emission Spectrofometry and inductively coupled plasma optical emission spectrometry (ICP-OES) methods can be performed. These methods can be analyzed in a short time without interference effects. In both methods, the calcium in the tooth is stimulated and the emission intensity it emits is measured as it becomes basic. These emission intensities are directly proportional to the calcium concentration. Also, in these methods, calibration graph or standard addition method is used for calcium determination. The roots were then bisected longitudinally, and the pulp tissue was removed with a toothbrush. All root halves (n = 100) were dehydrated in a sterilizer at 120 °C until they reached a fixed weight, as verified by consistent readings using a precision scale (Sartorius, Gotingen, Germany; precision = 0.0001 g). Thereafter, the specimens were covered with two consecutive layers of nail varnish, leaving the root canal surface exposed. The samples were randomly distributed into the following treatment. Groups: Group 1: 2.5% NaOCl Group 2: 17% EDTA Group 3: 17% EGTA Group 4: 15% EDTAC Group 5: 1% Tetracycline-HCl Group 6: 17% EDTA _ 2.5% NaOCl Group 7: 17% EGTA _ 2.5% NaOCl Group 8: 15% EDTAC _ 2.5% NaOCl Group 9: 1% Tetracycline-HCl _ 2.5% NaOCl Group 10: Distilled water (negative control) In each group, the specimens were immersed in a magnetic stirrer bath containing 10 ml of test solution for 1 and 5 minutes. In groups 1 and 10, the same samples (n = 10) were used for 1- and 5-minute treatments. Calcium is measured between 10 and 1000 ppm (mg/L) with Flame emission intensity. Calcium at a lower concentration cannot be measured. Inductively coupled plasma optical emission spectrometry (ICP-OES) is a widely used method recently. ICP-OES is an advanced high-end method of flame emission spectrophotometer. In this method, the energy source required for excitation is provided by plasma and its temperature is between 4000 and 10000 ⁰C. There is a certain wavelength of light to which each element is stimulated. The wavelength of the light used for calcium is 455,531 nm. At this wavelength, a calibration graph is prepared from standard solutions of calcium. Calcium in the tooth is measured using the calibration chart. The sensitivity of this method is high. Calcium analysis in ppm (mg/L) and ppb (µg/L) concentration can be analyzed with ICP-OES. In this method, the analysis takes minutes. Therefore, it is used in routine analysis. ConclusionUsing these methods, you can easily analyze the calcium found in the structure of the tooth. Also, disinfectant like hypochlorite used during canal treatment increases the calcium release of the tooth. Therefore, the released calcium can also be analyzed using these methods. Here, each sample takes at least 5 measurements and gives the results in accordance with the scientific representation.

Introduction: Obesity may cause progressive chronic kidney disease. Weight loss in the postoperative follow-up of bariatric surgery may improve renal function in these patients. Thus, the purpose of this study was to give insight on the subject using a sensible biomarker. Methods: This cross sectional study was performed in the Obesity Department from Campina Grande – Paraiba, Brazil. It was randomly enrolled 23 postoperative patients (7 bypass and 16 sleeve), with at least two years of follow-up, from the outpatient Department and 29 (18 bypass and 11 sleeve) in the preoperative period for bariatric surgery. They were homogeneously from both genders with ages ranging from 25 to 57 years. Serum levels of creatinine and cystatin C were measured, and the glomerular filtration rate (GFR) was estimated using the CKD Epi (chronic kidney disease epidemiology collaboration) cystatin-creatinine equation. The investigation was approved by the Ethics Committee. Results: The mean body mass index (BMI) of the preoperative group was significantly greater than the postoperative group (p ≤ 0.0001). The mean serum levels of C cystatin was significantly greater in the postoperative group as compared to preoperative (p= 0.0197). However, there was no mean difference between creatinine serum concentrations comparing the two groups (p = 0.3252). The mean glomerular renal function rates of the groups were similar (p = 0.1240). Conclusion: There is no definitive evidence for supporting the hypothesis that there is improvement in the kidney renal function after bariatric surgery in obese patients. Prospective cohorts are necessary to enlighten the answer for this important question.