design

Commonly referred to as an ecstatic, non-inflammatory disease, Keratoconus, usually bilateral and asymmetric, is characterized by progressive steeping and thinning of the cornea. This results in irregular astigmatism which compromises vision [1,2]. Traditionally, early Keratoconus stages have been treated by prescribing a hard contact lens to obtain a regular anterior optical surface. This tendency was discontinued when contact lens intolerance in advanced stages required the use of penetrating keratoplasty (PKP) or deep anterior lamellar Keratoplasty (DALK). An alternative technique of corneal cross-linking was designed in 2003 as a treatment option for keratoconus. The cornea measured at least 400 um thickness after epithelium removal and pre-operative maximum keratometry (Kmax) measured 58D or less. As a result, no corneal transplantation was required or postponed [3].

Background: Iron deficiency anemia is common during pregnancy since the overall iron requirement is greater than non-pregnant women and is associated with adverse outcomes. Iron deficiency (ID) is a state of insufficient iron to maintain normal physiological functions of tissues and leads to anemia.Objectives: To assess factors associated with the utilization of Iron with Folic acid supplement Among Pregnant Women Attending Antenatal care at Government Health Facilities and Family Guidance Clinic in Hawassa City, South Ethiopia.Methods: Institutional-based cross-sectional study design was conducted among 412 health providers who are working at public health institutes in Hawassa city from March to April 2015. Pretested Self-administered questionnaires were used to collect the data. The data was entered into Epi-data and analysed by SPSS version 26.0. Bivariate and multivariate regression analysis was used to see the significant association between the outcome and independent variables. Odds ratios and 95% CI will be computed to measure the strength of the association, p - value of ˂ 0.05 will be considered a statistically significant.Results: A total of 412 pregnant women who came to attend ANC at least for the second time were interviewed in seven health facilities. Our study showed that 333 (81%, 95% CI: 77.2 - 84.8) pregnant women reported taking IFA supplements and high compliance was 37.7% (95% CI: 32.5 - 42.9). In multivariable analysis, side effects and low acceptance of the supplement were significantly associated with compliance to IFA supplementation (p < 0.05).Conclusion: There is a relatively better level of compliance towards IFA supplementation compared to other national data. Pregnant women should be counseled regarding how to manage the side effects of IFA supplements during ANC. Further research has to be done on the acceptability of the supplements.

Introduction: PCOS is a common cause of female infertility. Although PCOS patients are characterized by producing an increased number of oocytes, they are often of poor quality, leading to lower fertilization, cleavage, and implantation and higher miscarriage rates.Aims: The present study aims to identify the effect of various PCOS phenotypes on oocyte competence in an ART cycle.Settings and design: A retrospective observational study. Methods and material: The study group included 102 women with PCOS as a main cause of infertility. Data was collected over a period of one year (2017-18). These women were divided into four groups on basis of PCOS phenotypes (A-D) and the relevant clinical data and the ART outcome were noted. Statistical analysis was done using SPSS statistical package. Data presented as mean ± SD which was compared using the ANOVA test. A p - value < 0.05 was considered statistically significant.Results: Out of 102 PCOS women, 23.52% women had phenotype A, 11.76% had phenotype B, and 45.09% and 19.60% had phenotype C & D respectively. Good quality embryos formed (p - value 0.01) were lower in Group B vs. other groups. However, clinical pregnancy rates were comparable in all groups.Conclusion: The reproductive potential of women with PCOS varies with the oocyte health and it largely depends on PCOS phenotype. Women with PCOS phenotype B might have poor IVF/ICSI outcomes with regard to the number of oocytes retrieved and embryos formed. PCO morphology might carry an advantage with regards to the number of oocytes retrieved and better quality embryos. It seems that hyperandrogenism in combination with chronic anovulation is associated with poor oocyte competence and hence, a negative impact on embryo quality and clinical pregnancy rate. Further studies with a larger sample size are required to further support it.Key messages: Oocyte competence in various PCOS phenotypes.

Introduction: The world is currently facing the SARS-CoV-2 pandemic with evolving 2nd wave. The COVID-19 patients present most commonly with Severe Acute Respiratory Illness (SARI) in an emergency room with acute onset fever, cough, and breathlessness. However, not all SARI cases as per definition are due to COVID-19 infection, which is well proven in this case series of 113 cases of SARI. This is just the opposite of the other SARI series done in the pre-COVID-19 era. Also, no previous SARI case series data has shown significant association with Diabetes Mellitus, including new-onset diabetes thus figuring out the major Pathophysiological association of COVID-19 with glucose metabolism and has a bearing on the pathogenesis, treatment, and outcome of COVID-19 infection and perpetuity of pandemic of this magnitude. Here we raise concern for the first time about the growing association of an infectious pandemic with the lifestyle disorders which are non-communicable diseases but carry with them the potential of fertile soil for rapidly spreading epidemics.Aim and objective: To find out the etiology, clinical profile, treatment outcome, and mortality rate in different sub-groups of SARI cases in a tertiary care hospital and the incidence of new-onset Diabetes Mellitus in them and to investigate theoretically the hypothesis that maintaining normal glucose metabolism could prevent progression of a mild Flu-like illness (FLI) to a severe form of Severe Acute Respiratory Illness (SARI) and consequent complications such as Cytokine Storm Syndrome and Multi-Organ failure.Design: Retrospective, single-center case series of 113 SARI patients at a tertiary care hospital in Agra India between 1 March- 30 October 2020.Main outcome: The demographics, clinical, pathological, imaging, and treatment outcome data were collected. The SARI cases analyzed were defined as “Severe acute respiratory infections (SARIs) an acute respiratory illness of recent onset (within seven days) manifested by fever (≥38°C), cough and shortness of breath or difficulty in breathing requiring hospitalization and were sub-classified according to the primary etiology producing SARI in them. The findings were compiled and compared. Conclusion: Of the 113 patients of SARI – 32.7 %were associated with Diabetes, with 9.74% new-onset Diabetes and 26 % previously known Diabetes. This was mainly due to SARS-CoV-2 (24 Diabetics out of 52 COVID-19 cases- 46.1 %).The Average hospitalization stay of SARI cases was 10 days with a maximum in SARS-CoV-2 and a minimum stay of 5.22 days in Bacterial Pneumonia and 5.66 days in Koch’s Lungs.The death rate was maximum (4 out of 26) 15.3%. Hospitalized TB/Koch’s Lung patients who presented as SARI and 3.8% in Bacterial Pneumonia, 2.43% in SARS-CoV-2, and <1% in Sepsis.Those SARI cases who were euglycemic at the time of initial presentation recovered early and carried a good prognosis with less mortality as compared to those who were hyperglycemic on presentation. Also, those FLI cases who maintained euglycemia or did not have any other risk factor which predisposes them to stress (Diabetes, Prolonged fasting, Obesity, major organ disorder, Psychological disorder, and Cancer) did not progress to SARI as the endogenous steroid secretion and sympathetic activation did not occur, the intracellular pH levels remained in the alkaline range.10.18% of cases developed new-onset diabetes (a total of 11 cases) out of which 10 were in COVID-19. Thus 19.2% incidence of new-onset diabetes in SARS-CoV-2 and a prevalence of 26.9% in SARS-CoV-2, making total diabetes 46.1% in SARS-CoV-2, and out of all SARI cases, 26 % of patients developed pulmonary fibrosis with consequent long-term complications. In COVID-19 patients, it was seen only in diabetics SARS CoV-2 male patients, thus no death in non-diabetic females in COVID-19 in this case series.

For over two years, COVID-19 pandemic has been a major global health concern and threat to human life. In the SARS-CoV2 macromolecules, the 3-chymotrypsin like protease (3CLpro or main protease) has been identified to be crucial and essential for viral survival, processing of the viral polyproteins and has been explored as a target in COVID-19 drug discovery. Although vaccines and other various inhibitors have been designed and launched, the emergence of the variant of this virus has put an unrelenting effort of researchers to this end. Also, the high cost of manufacturing these molecules coupled with the occurrence of drug resistance is a concern.Herein, Pefloxacin and its derivative for the first time were screened for their inhibitory activity against the SARS-CoV2 main protease through in silico analysis and their pharmacokinetic properties were evaluated. Interestingly, from the docking results, they both bind with high affinity at the active site of the protein. Moreover, they showed excellent pharmacokinetic and drug - likeness properties. Derivatization of Pefloxacin at the C7 position prevents its blood-brain barrier permeability. Overall, the dual antibacterial and potential antiviral activities of these two molecules make them promising drug candidates for COVID-19 management.

High fluoride level in drinking water is an endemic public health concern in East Africa. Unlike in Kenya where it is absent, the Nalgonda technique, a defluoridation method that uses two chemicals, alum, and CaO, has seen mixed results in its application and adoption in Ethiopia and Tanzania. This has been due to the low capacity of communities to manage the process and the breakdown in the supply chain of chemicals used in the technique. In the present study, we attempted to bridge the gap in the chemical deficit by investigating the possible substitution of CaO with leachate from wood ash, a by-product of wood combustion commonly found in Kenya. The leachate was prepared from one part of wood ash mixed with two parts of distilled water and stirred for 24 hours followed by decantation. The new technique, the Homa method, using alum and wood ash leachate was then tested on H2O samples from three areas in Kenya with high F- concentrations ranging from 5.1 mg L-1, 9.1 mg L-1 to 91.0 mg L-1. The determination of F- concentration by SPADNS Spectrophotometry was applied throughout the experiment. Four levels of alum i.e. 1%, 2%, 3%, and 4% were dosed on five volumes of water i.e. 100, 200, 300, 400, and 500 ml raw water at 5.1 and 9.1 mg L-1 F-. For water samples at 91.0 mg L-1 F-, the same volumes were treated with 5 higher alum levels i.e. 5%, 6%, 7%, 8%, and 9%. The final pH was then adjusted to 7 with ash leachate for defluoridation. The set-up was a factorial design experiment where the final F- concentration was the dependent variable and the volume of raw water, the percentages, and volume of alum and wood ash leachate constituted the different factors. A fitted multivariate regression model of the general form; where Y = Residual fluoride, X = wood Leachate volume, W = alum Concentration, X*W = Interaction α, β, γ were regression coefficients, ε = error term, showed that only in the Baringo area did we have an interaction between wood ash leachate and alum concentration significant (p < 0.05). Defluoridation occurred (p < 0.05) at as low as 10% and as high as 99%, depending on the initial F- content. Total coliform decreased from 310, 290 and 270 count/l respectively to zero. Unfortunately, high chemical and TDS (from 558 mg L-1 to more than 9,000 mg L-1) enrichment were recorded in addition to the mixed data on turbidity. The overall results show that wood ash can substitute CaO in the Nalgonda process. Further investigation is however required to make it applicable for potable water production.

Carbonic anhydrase VI (CA VI) catalyzes the reversible hydration of carbon dioxide in saliva with possible pH regulation, taste perception, and tooth formation effects. Objective: The aim of this work was to undertake a systematic review regarding the relationship between the expression/activity of CA VI in saliva and in dental biofilm and caries experience. Study design: Five databases were searched until February 2020. The composition was based on the PRISMA statement and on the PICOS model. First author, year, subject characteristics, analysis performed, outcome, measures & variables were extracted. The used terms were “carbonic anhydrase VI”, “saliva”, “dental biofilm” and “dental caries”.Results: Five studies in the English language were selected for this systematic review and the main discussed topics were the expression/activity of CA VI in saliva and/or in the dental biofilm of children, and its relationship with dental caries. Conclusion: Salivary carbonic anhydrase plays an important role in the caries dynamics process since there is an association between the expression/activity of CA VI in saliva and the experience of caries. Thus, this protein can predict the risk of dental caries in young patients.

Background: More than 1 million intravenous chemotherapy infusions are given worldwide each day which leads to extravasation. Health professionals must know the drugs that cause tissue injury and take the necessary measures to prevent extravasation.Objectives: The study aimed to assess the knowledge regarding the management of extravasation of chemotherapeutic drugs before and after the implementation of a structured teaching program among staff nurses.Method: The pre-experimental group pre-test and post-test designs were adopted for the study. The convenience sampling technique was used to obtain 30 staff nurses of Ramaiah Medical College Hospital, India. Both Pre-test and Post-test were performed using the same structured knowledge questionnaire followed by 45 minutes of the structured teaching program. Data were processed through Statistical Package for Social Sciences version 20 and analyzed using descriptive and inferential statistics.Results: More than half of the subjects were female (66.7%) and 36.7% of the subject had more than 10 years of professional experience. Most of the subjects (70%) had inadequate knowledge during the pretest. The mean knowledge score was 15.33 ± 4.003 and 24.67 ± 5.384 in pre-test and post-test respectively. There was a significant difference in pre-test and post-test knowledge scores regarding the management of extravasation of chemotherapeutic drugs. Conclusion: The Study concluded that the structured teaching program was significantly effective in improving the knowledge regarding the management of extravasation of chemotherapeutic drugs among nurses.

Objective: Foot and mouth disease (FMD) is a highly infectious and economically important disease affecting cloven-hoofed domestic and wild animals. Early diagnosis and serotyping of the agent are very important to effectively design and implement the control approach. This study was conducted on serum samples collected from Amhara, Tigray, Oromia and Addis Ababa between October 2018 to February 2020. The animals were kept under a semi-intensive to an extensive system of rearing. Serum samples with low OD values (positive) using competition NSP-ELISA were subjected to serotyping ELISA. Results: In the present study, three serotypes were identified from 186 NSP ELISA positive sera of which 156 serotype O, 40 serotypes A and 28 serotype SAT2. In this analysis, multiple serotype infection was observed which is why the number of serotypes was beyond the samples analyzed. Among 23 samples from Addis Ababa 10, 3 and 5 were O, A and SAT2 serotypes respectively, while in samples from the Oromia region 12 were O and 3 were SAT2 serotypes. From the Amhara region, 99 samples analyzed were found to be serotype O and SAT2 in 7 of the serum samples. From the Tigray region, 30 samples were seen to have Serotype O infection, whereas 13 of them were SAT2. The proportion of serotypes identified based on the production system practices was also found that semi-intensive production takes the largest share in all three serotypes followed by extensive production. Generally, early determination of the serotype from past infection helps to aware of the epidemiology as well as the infection immunity of the herd/individual animals.

Neuropathy is when nerve damage interferes with the functioning of the peripheral nervous system (PNS). When the cause can’t be determined, it’s called idiopathic neuropathy(Idiopathic neuropathy, now designated as chronic idiopathic axonal polyneuropathy (CIAP).There are three kinds of nerves within the PNS. Sensory nerves relay messages from the sense organs to the brain. This allows sensations of temperature and touch. Motor nerves transmit signals from the brain to the muscles. This helps the brain control the muscles. Autonomic nerves control body functions like heart rate, breathing, and digestion.Damage to nerve cells can affect how the PNS communicates with the rest of the body. Symptoms can include numbness, pain, and balance issues.It’s called acute neuropathy when symptoms develop suddenly. Alternately, it’s called chronic neuropathy when symptoms start slowly and increase over time. Diagnosis involves physical examination and review of medical history. Diagnostic testing may include blood tests, nerve testing, and imaging tests.There is no cure for idiopathic neuropathy. Treatments including medication, physical therapy, and lifestyle modifications can help you function and feel better.We report a case of idiopathic polyneuropathy presented with frequent acute pulmonary edema for a year.

Pretreatments and drying are commonly used before drying tomatoes to inactivate enzymes, improve the drying process, and improve the quality of dried tomato powders. In this review, the effects of different pretreatments (osmotic solutions), dehydration methods, and packaging materials on the quality attributes of tomato powder were summarized. These include pretreatments and osmotic agent solutions (potassium metabisulfite, calcium chloride, sodium metabisulphite, ascorbic acid, citric acid, sodium chloride, and sodium benzoate), thermal blanching (steam blanching and hot water) and non-thermal-processes-like-freezing, sulfuring, etc. and drying methods (oven, sun, and indirect solar dryer). The tomato powders were dried to preserve, store, and transport them. Drying implies not only physical changes, which the consumer can easily detect through visual inspection but also chemical modifications. These are responsible for alterations in color, flavor, and nutritional value, which compromise the overall quality of the final tomato powder. Maximum lycopene, vitamin A, and C contents were found in freeze-dried and direct sundried than samples dried using other methods at low drying temperatures. Freeze driers showed in keeping the nutritional quality of tomato powder with a combination of different pretreatments. Different pretreatments including osmotic agent solutions have their own merits and demerits for the final tomato powder. To overcome the drawbacks of nutritional quality, non-thermal pretreatment categories may be a better alternative to thermal blanching, and more fundamental research is required for better design and scale-up.

Background: A large body of evidence suggests that child abuse and neglect by a caregiver is a recurrent event linked to increased psychopathology symptoms. The Childhood Trauma Questionnaire (CTQ) is commonly used to assess abuse/neglect during childhood. However, even though the Minimization-Denial (MD) subscale was originally designed to assess response bias (i.e., underreporting of childhood maltreatment), it is possible that the scale may reflect coping strategies that play an effective role in the relationship between childhood trauma and their negative outcomes. Also, even though MD has been associated with decreased psychopathology symptoms, it is also strongly associated with other scales of the CTQ. Method: This study (n = 133) examined whether (1) the MD-scale is negatively associated with alexithymia, emotion dysregulation and psychopathology, if (2) these associations will hold when adjusting for different subtypes of abuse and neglect and (3) and the role of MD as a possible moderator in these relationships. Results: The analyses showed that, although MD scores have relatively strong and (mostly) significant (negative) associations with the CTQ, emotion dysregulation strategies and psychopathology symptoms, these associations were weak and failed to remain significant when adjusting for the effect of CTQ. Conclusion: Our findings suggest that the MD scores should be viewed as an accurate reflection of the absence (or little) of exposure to childhood abuse/neglect. 

Saliva is produced by and secreted from salivary glands. It is an extra-cellular fluid, 98% water, plus electrolytes, mucus, white blood cells, epithelial cells, enzymes, and anti-microbial agents. Saliva serves a critical role in the maintenance of oral, dental, and general health and well-being. Hence, alteration(s) in the amount/quantity and/or quality of secreted saliva may induce the development of several oro-dental variations, thereby the negatively-impacting overall quality of life. Diverse factors may affect the process of saliva production and quantity/quality of secretion, including medications, systemic or local pathologies and/or reversible/irreversible damage. Herein, chemo- and/or radio-therapy, particularly, in cases of head and neck cancer, for example, are well-documented to induce serious damage and dysfunction to the radio-sensitive salivary gland tissue, resulting in hypo-salivation, xerostomia (dry mouth) as well as numerous other adverse Intra-/extra-oral, medical and quality-of-life issues. Indeed, radio-therapy inevitably causes damage to the normal head and neck tissues including nerve structures (brain stem, spinal cord, and brachial plexus), mucous membranes, and swallowing muscles. Current commercially-available remedies as well as therapeutic interventions provide only temporary symptom relief, hence, do not address irreversible glandular damage. Further, despite salivary gland-sparing techniques and modified dosing strategies, long-term hypo-function remains a significant problem. Although a single governing mechanism of radiation-induced salivary gland tissue damage and dysfunction has not been yet elucidated, the potential for synergy in radio-protection (mainly, and possibly -reparation) via a combinatorial approach of mechanistically distinct strategies, has been suggested and explored over the years. This is, undoubtfully, in parallel to the ongoing efforts in improving the precision, safety, delivery, and efficacy of clinical radiotherapy protocols/outcomes, and in designing, developing, evaluating and optimizing (for translation) new artificial intelligence, technological and bio-pharmaceutical alternatives, topics covered in this review.

Meat species identification has become essential with the increasing events of frauds like the illegal slaughter of cows, meat adulteration, and substitution. Food scam directly influences public well-being, trade, and wildlife. In Pakistan, donkey meat is used as adulterants for cow meat and is considered Haram in Islamic concepts. In this study PCR, based detection methods are used for identification purposes. The mitochondrial gene cytochrome b has been used in this study to identify the origin of meat specie. Specie-specific primers of cyt b of cow and donkey were used for identification. DNA from different binary ratios of cow and donkey meat was extracted by the phenol-chloroform method. Ratios were made from 1-10 and extracted DNA was subjected to PCR to amplify the target fragment of the cyt b gene. Primers were sensitive to identifying species origin in all meat ratios. Multiplex PCR was designed to identify both species and the results were analyzed by gel electrophoresis. Fragment size of 309bp for cow and 475bp for donkey was observed.Results of the current study conclude that PCR assays, including multiplex PCR, is efficient and has a high sensitivity for even small amount of meat. It is concluded that multiplex PCR is useful and reliable for adulterated meat detection.

In our study, we aimed to show that alternative iron salts containing different additives are safe to use in patients who have type 1 hypersensitivity reactions to iron drugs and need iron replacement therapy.Materials and methods: Between January 2022 and June 2022, patients who had previously developed type 1 hypersensitivity reactions with iron preparations and needed iron replacement were included in the study. The study was designed retrospectively. Skin tests were first performed on patients to demonstrate a type 1 hypersensitivity reaction. If skin tests were negative and there was no history of life-threatening anaphylaxis, oral provocation tests were continued. If the absence of variability in symptoms and perimeter values, the drug allergy test was considered negative. Results: Twenty-two patients were included in the study. Twenty-one of the patients were female and one was male. Iron deficiency anemia was found in nine patients, and low iron stores in thirteen patients without anemia were found. Type 1 hypersensitivity reaction developed with Iron 3 Carboxymaltose in 7 patients, Iron 2 Sulfate in 5 patients, Iron 2 Glycine in 4 patients, Iron 3 Hydroxy Polymaltose in 4 patients, Iron 2 Fumarate in 1 patient and Iron 3 Hydroxide Sucrose in 1 patient. Allergy tests with all alternative iron drugs containing additional additives were negative.Conclusion: If patients with allergic reactions cannot be referred to allergy clinics, we think that oral iron salts with different additives can be used after the first dose is given in the hospital under general anaphylaxis precautions. We show that oral iron salts containing different additives can be safely used.

Introduction: In an earlier study, we described and validated a VKA dose-finding algorithm (B2A), based on a novel bidirectional factor (BF). We designed a prospective study to evaluate the B2A in a daily care setting. Methods: In this open-label prospective study, we compared the outcomes of the B2A over the year 2020 with the outcomes of the previous year (2019), using regular algorithms. The outcomes were the duration of Time in the Therapeutic Range (TTR), the percentage of automated dose proposals (PAuP) and the percentage of accepted dose proposals (PAcP). The data were obtained from three anticoagulation centers in the Netherlands, in four locations. The outcomes of this study were based on a non-inferiority level.Results: The TTR over the year 2020 was at least non-inferior compared with the standard of care treatment. The percentage of automated proposals increased in all centers to approximately 96% of all dosages. Conclusion: The B2A performs non-inferior compared with the existing algorithms and in some aspects even better.

mRNA drugs are synthesized using cell-free systems without complex and stringent manufacturing processes, which makes their preparation simple, efficient, and economical. Over the past few years, mRNAs encoding antibodies have been one of the research frontiers of antibody drug development. In cancer immunotherapy, mRNAs encoding immune checkpoint antibodies may be advantageous regarding antibody persistence and durability of the anti-tumor immune response of patients. In our previous study, a candidate antibody—AET2010—targeting the novel immune checkpoint TIGIT was reported. Its anti-tumor activity was also investigated using adoptive transfer of NK-92MI cells in a xenograft mouse model, but the limitations of the model did not facilitate precise evaluation. In the present study, we further investigated the therapeutic potential of AET2010 for cancer in TIGIT-humanized BALB/c mice. Next, we explored the design, synthesis, and optimization of mRNAs encoding AET2010 and ultimately obtained a candidate mRNA (mRNA-BU) with favorable in vitro and in vivo expression levels of active AET2010. Particularly, lipid-nanoparticle-encapsulated mRNA-BU delivered to mice produced AET2010 with significantly higher peak concentration and expression duration than an equivalent dose of original AET2010. This study provides a sound basis for developing novel drugs targeting TIGIT.

Dentistry is an ever-evolving field that has seen significant advances in recent years. This article sheds light on some of the current and emerging trends in oral health care, including digital dentistry, regenerative medicine, and the use of lasers. For example, digital dentistry involves the use of computer-aided design and manufacturing technology, which enables more accurate and efficient production of dental devices. On the other hand, regenerative medicine and nanoDentistry can be considered promising area that combines the use of stem cells, growth factors, biomaterials, and nanotechnology to regenerate damaged tissue and improve treatment outcomes. Lasers are increasingly being used in dentistry for a range of applications, including the treatment of gum disease and teeth whitening. Other developing technologies such as 3D printing and artificial intelligence are also being increasingly incorporated into dentistry, providing improved treatment options for our patients. Last yet definitely would/will not least, controlled drug delivery systems are being developed to deliver drugs to specific target sites in a localized and sustained manner, reducing the risk of adverse effects. Currently, these emerging trends are transforming the landscape of odontology and beyond. Hence, in this mini-Review, we explore such trends in oro-dental and cranio-maxillo-facial indications to highlight the potential benefits, advancements, and opportunities of applications for improved patient care.

Background: Pregnant individuals with early cervical dilation have a high risk for preterm birth. The authors encountered cases where cervical dilation increased after anesthesia administration for a cerclage. Objective: The primary objective was to assess if a change in cervical dilation after anesthesia administration for a cerclage was associated with a shorter latency to delivery. Study design: This was a retrospective chart review of pregnancies from January 1, 2011, to December 31, 2021, who had a cerclage and delivered at our institution. Maternal demographics, obstetrical history, operative details, and delivery information were collected. Multi-fetal gestations, un-indicated cerclages, and abdominal cerclages were excluded. The primary outcome was the difference in cervical dilation between the office and the operating room after spinal anesthesia administration. A multivariable regression was performed. Results: A total of 183 pregnancies were included. The mean gestational age at cerclage placement was 18 weeks (STDEV 3.6). Twenty-nine percent of patients (53/183) were more dilated in the operating room compared to the office The latency between cerclage and delivery was not different if there was a cervical change between these settings (p = 0.655). There was an increased risk for preterm delivery with dilation in the office (OR 1.01, CI 1.01 to 2.5), but not with dilation in the operating room (OR 1.4, CI 0.9 to 2.0). Conclusion: Cervical dilation between the office and the operating room is different. Pregnancies with more dilation delivered at earlier gestations. However, a change in dilation between the office and the operating room was not associated with a shorter latency. 

Background: It is unknown what effect the menstrual cycle can have on the susceptibility to trauma following sexual assault. Objectives: To compare the incidence of genital injuries following sexual assault in women with relationship to the three phases of the menstrual cycleMethods: The design was a retrospective, cohort analysis set in a community-based nurse examiner program over a five-year study period. Sexual assault victims were between the ages of 13 - 40 years and agreed to a forensic examination. The menstrual cycle was divided into three phases: follicular, luteal and menses phase. The primary outcomes were the frequency and type of genital injuries documented in relation to the different phases of the menstrual cycle.Results: Case files of 1376 cases of sexual assault were reviewed; 682 (49.6%) met the inclusion criteria. A total of 220 victims (32.3%) were in the follicular phase, 361 (52.9%) were in the luteal phase and 101 (14.8%) were in the menses phase. The three groups were comparable in terms of demographics, assault characteristics, and overall frequency of non-genital injuries. Assault victims in the follicular phase of the menstrual cycle had significantly more documented genital injuries (72.3%; 95% CI 66.4 - 78.2) compared to the luteal phase (64.0%; 95% CI 59.0 - 68.9) and the menses phase (58.4%; 95% CI 48.8 - 68.0). Conclusion: Forensic examiners documented more genital injuries in the follicular phase of the menstrual cycle. Sex hormones may have confounding effects through influences on vaginal epithelial and mucosal integrity.