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Introduction: The World Health Organization (WHO) strategy for leprosy control from 2021 to 2030 focuses on interrupting transmission, reducing autochthonous cases to zero, and using a safe and effective vaccine and chemoprophylaxis. In 2020, 127,396 new cases were registered in the world, 19,195 new cases in the Americas, and, of these, 17,979 cases in Brazil, about 93.66% of the total in the Americas. Brazil is classified as a country with a high burden of the disease, occupying the 2nd place in the world, behind only India (WHO, 2020). Análise do período de 2010-2015 em publicação recente9, apresenta as seguintes cidades no estado do Pará nas quais se observou maiores taxas de incidência (detecção): Marituba, Belém, Marabá, Parauapebas e Altamira [9]. Material and method: This is an analytical retrospective study carried out in a database - Epi-Info resulting from records of Surveillance and Seroprevalence actions in five endemic municipalities for leprosy located in the Southeast and West of Pará. The following variables were analyzed: age, sex, Clinical Classification, vaccination status with BCG, and the result of the search for IgM antibodies against PGL-1 of Mycobacterium leprae by the “In house” ELISA technique. Results: We evaluated 1551 records examined in the laboratory from 2014 to 2016, which were classified into 123 Multibacillary -MB patients (123/1551 = 7.93%); 71 Paucibacillary-PB patients (71/1551 = 4.57%); 451 Intradomicilliary Consanguineous Contacts - CCOSI (451/1551 = 29.07%) and 906 Non Consanguineous Contacts - CNCOS (906/1551 = 58.41%). 57 MB patients (13.47%), 13 PB patients (3.07%), 133 CCOSI (31.44%) and 220 CNCOS (52.00%) were positive for PGL-1. The correlation of the Classification with the vaccination status showed 57 MB patients without any BCG (57/125 = 45.6%) and only 3 patients with two doses of BCG (3/125 = 2.4%); 17 PB patients without any dose of BCG (17/69 = 24.63%); 80 CCOSI without any BCG (80/455 = 17.58%) and 171 CNCOS (171/906 = 18.87%). The odds ratio (OR) in the analysis between unvaccinated MB patients compared to CCOSI was statistically significant (OR = 14.25; p ˂ 0.0001). The study shows the importance of using the BCG vaccine in healthy contacts of patients with leprosy, as it shows the probability of unvaccinated individuals being 14.25 times more likely to become ill with Multibacillary forms compared to CCOSI. In addition, the BCG vaccine has been in use for 80 years and is the only vaccine that we can use in leprosy control programs. Conclusion: Although the leprosy epidemiological data analyzed recently (2010 - 2015) show a downward trend in the main indicators in Pará, such as the detection of new cases and prevalence, the endemic municipalities are still classified as hyperendemic for the population under 15 years of age and This proves that Surveillance is essential, as well as BCG vaccination according to the Ministry of Health Standards.

Periodontal suturing beyond the surgical elements it provides precedes the selection of the type of suture versus the fact that it is manipulated with periodontal soft tissue. This fact is the basic element in the selection of the type of suture indicated for use and the way of suturing, which in the periodontal surgeon with experience is performed instinctively without thinking.The article is of the review type, bringing a summary of the published data about the suturing method needed for the periodontal application.Conclusion: The type of suture indicated as a primary indication has a clinical case that is indicated based on clinical diagnosis, but the selection of suture type depending on the material or needle is performed based on the clinical area conditioned by minimal manipulation space and the possibility of laceration of periodontal tissue.

Genome-wide association studies (GWAS) have uncovered thousands of single nucleotide polymorphism (SNP) loci that are associated with complex traits. However, the majority of GWAS discoveries are located in non-coding regions and the biological mechanisms behind these associations are not well understood. Transcriptome-wide association studies (TWAS) have gained popularity in recent years by generating biological interpretable discoveries and facilitating the identification of novel associations that have been missed by GWAS. TWAS has identified more than hundreds of susceptibility genes for many complex diseases and traits, including cancers. Here, in this review, we first summarize TWAS methods, then discuss the opportunities for cancer studies and finally review current challenges and future directions for this method.

More than 200 countries have been devastated by the SARS-CoV-2 pandemic. The health workers exposed to SARS patients have been confirmed to be infected with coronavirus (SARS-CoV-2), regardless of the degree of their exposure. The increasing complexity of virus existence and heterogeneity has cast doubt on disinfectants as a viable choice. Hence, the present systematic review aims to achieve the comparative analysis of established disinfectants against enveloped and non-enveloped viruses including SARS-CoV and MERS-CoV. Three databases (Pubmed, Google scholar, and Medline) were searched to frame the systematic review. Our comparative analyses with 34 studies have found that 85% ethanol-based hand sanitizers and 7.5% Povidine Iodine based soaps/surgical scrub could be used to deter the SARS-CoV-2 virus as preferred hand sanitizers. For surface eradication, 0.5% sodium hypochlorite or a mixture of glutaraldehyde, Quaternary Ammonium Compounds (QAC), and isopropanol could have more efficacies as compared to hydrogen peroxide, phenol, and QAC alone. Moreover, the accelerated hydrogen peroxide as an active ingredient in the automatic quick surface disinfectant (tunnel system), maybe a positive indication for quick whole-body sanitation. Additionally, the alternative method for avoiding the rapidly increasing chain of infection with SARS and restarting regular life has been exclusively discussed.

The study of circadian rhythms of changes in the performance of body systems allows us to evaluate the regulatory systems and is an important tool in diagnosing the severity of the course and prognosis of the outcomes of various diseases. 

Introduction: Treatment failure and claims against physicians may have many negative consequences. Orthopedic surgeons have always been among the most used specialists. Therefore, the investigation of causes and the process of these claims can help reduce the negative effects of medical malpractice on physicians and society.Materials and methods: This retrospective study investigated all medical orthopedic negligence cases in Sari, Iran, from March 2015 to March 2020. Data were collected using a researcher-made checklist and analyzed in SPSS software (V-21).Results: Out of 57 finalized cases investigated in this study, surgeons were found liable in 23 (40%) cases. The mean ± SD age of patients was 41 ± 19.3. Moreover, the level of education had a positive correlation with the surgeon’s liability. The most common cause of complaint was reduced Range of motion (ROM) and the most common type of complained surgery was “open reduction & internal fixation” (ORIF). None of the surgeons were found liable due to surgical site infection or device failure. The mean ± SD time for the file processing was 11.1 ± 10.1 months. The mean indemnity payment was 320 million Iranian Rials (9.7% of indemnity for death in Iran).Conclusion: The most effective way to reduce medical complaint cases is to increase the knowledge and skill levels of physicians. The lack of a blinded arbitration system in both organizations could lead to bias in the case assessment process. Moreover, considering the long processing time of the claims, it is recommended that new technologies should be used to reduce the time and increase the accuracy of the final verdict. The absence of a ‘no-fault’ compensation program is a significant flaw in Iran violating patients’ rights. Also, more studies are needed to evaluate justice and equality in Iranian medical commissions.

SARS-CoV-2 a virulent disease that established the entire wide world due to its severity. Its 1st case was rumored in Wuhan, China within the year 2019 and it had been the beginning of this pandemic. This virus killed virtually a complete of 4,465,683 folks round the globe until date. Despite the fact that viral co-infections have the ability to alter the host’s illness pattern, few research have looked at the disease outcomes in patients who are infected with HIV and hCoVs. Despite the fact that HIV-positive people can be infected with hCoVs, researchers are now revealing that their chances of acquiring serious CoV-related disorders are typically similar to what is seen in the general population. The relation between SARS-CoV-2 and HBV was summarized rather HBV effects the severity of COVID patient or not. SARS-CoV-2 could be a severe acute metabolic process syndrome. Scientists found ways in which to treat this virus, some were useful and alternative weren’t that a lot of effective. Immunizing agent was one among the most important considerations for the entire world. This virus conjointly fashioned an entry for alternative co-infections too. SARS-CoV-2 and influenza virus, both causes respiratory diseases which confer as an extensive array of illness from asymptomatic or benign to critical disease and death. Also the mode of transmission and symptoms of influenza virus and SARS-CoV-2 are same. Viral and bacterial rate is higher in SARS-CoV-2 negative patient but are comparable. Serologies facts confirmed that patients with effective results for dengue virus (DENV) NS1 antigen and anti-dengue IgM were also attentive to COVID-19 speedy antibody tests, suggesting dengue COVID-19 co-infection. Mixed infection of dengue and COVID-19 needs unique interest from all dengue-common nations in Asia, especially the ones with limited resources. To our knowledge, this is the primary showed case of co-infection of dengue and COVID-19 in Indonesia. During patient’s TB course, COVID-19 can occur at any time with worse consequences for the patients who are affected by active pulmonary disease.

Chronic Lymphocytic Leukemia (CLL) is a common clonal neoplasm of small, mature B-lymphocytes. CLL is a heterogeneous disease with different clinical presentation, response to treatment and survival. This heterogeneity could be explained by the different genetic aberrations in CLL [1]. The most important chromosomal defects correlated to a poor prognosis are 17p13.1 deletion (loss of TP53) or 11q22.3 deletion (loss of ATM) [1,2]. In the era of new drugs in CLL it is mandatory to perform the interphase fluorescence in situ hybridization (FISH) test in order to assess these aberrations, before starting any lines of therapy [3]. Moreover, recent evidence suggests that complex karyotype (CK) with structural chromosomal aberrations identified by using chromosome-banding analysis may be relevant to better define CLL prognosis. It is known that 80% of CLL patients harbor at cytogenetic aberrations [3].

To reduce bleaching side effects, the use of low concentrations of Hydrogen Peroxide (HP) agents associated with hybrid light (violet LED/Diode Laser) has gained interest. Case report: The aim of this report is to describe a case of a 16-year-old patient that presented a complaint related to the color of his teeth and a maxillary midline diastema. In-office bleaching with 6% HP associated with hybrid light (violet LED/Diode Laser) was performed. The bleaching gel was applied once on the teeth and light-activated for 1 minute (15 times) followed by 1min intervals (15 times) with a total bleaching time of 30 minutes. After the bleaching procedure, the teeth were polished and the desensitizer was applied for 4 minutes. Two bleaching sessions were performed at a 1-week interval. The diastema was closed with direct resin composite restorations without any tooth preparation. The conventional 3-step bonding agent was used and A1 dentin shade and B1 enamel shade were used followed by polishing discs. At 3-year recall, discoloration and fractures were not found on the the teeth or restorations and patient was completely satisfied. Conclusion: the conservative and safe option of bleaching with a low-concentrated HP gel associated with violet LED light is an interesting option for young patients and presents longevity over time.

Introduction: Oral habit is common in childhood and it is proven to cause multiple adverse effects on oral and general health, while oral habits in the adult population are under looked. The prevalence of oral habits varied among different societies. The extent of these effects varies depending on a wide range of variables including the actual habit, the duration, and the intensity of the oral habit. Objectives: The primary objective is to determine the prevalence of oral habits in adults in Riyadh, Saudi Arabia, and the secondary objective is awareness of different types of oral habits and their adverse effects.Methods: Descriptive cross-sectional study using questionnaire through google form which will address the prevalence of 5 Oral habits in the adult population, Riyadh, Saudi Arabia such as nail biting, chewing on pens/pencils/Miswak, using the teeth as a tool, chewing ice, and teeth clenching/grinding and bruxism. Also, it will address the awareness of these 5 oral habits and their adverse effects on oral health and prevention modalities. Results: There were 220 participants. The majority were Saudi (52.7%), females (83.2%) with bachelor’s degrees (63.6%) and around fifty percent with age below 30 years old. The most prevalent pattern was using teeth as a tool (46.8%), followed by chewing ice (43.6%) and nail-biting (39.1%). All five habits were mainly started in childhood; however, a respectable percentage of beginning is still reported during adulthood, particularly for clenching/grinding/ bruxism and chewing ice, with a ratio of 36.4% and 25%, respectively. Most participants who reported clenching/grinding/ bruxism and nail-biting were related to stress (75.3%, 48.8%, respectively). The majority reported that oral habits could harm teeth (82.3%) and could be preventable (78.6%).Discussion: Most of the studies concentrate on oral habits in children while few studies had concentrated on oral habits in adults. Oral habit is not uncommon in adults, they have either to continue childhood bad habits or practice new oral habit. The adverse effect varies widely on oral and general health. Although the adult population is aware of these side effects few only seek medical advice.Conclusion: In Saudi Arabia, oral habit is not uncommon in adults. So the recommendation for the prevention of oral habits is to embed it in all public services, at strategic and operational levels.