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Almost half of the crowns that were considered clinically acceptable had some vertical or horizontal marginal discrepancy on radiographic evaluation.

Almost half of the crowns that were considered clinically acceptable had some vertical or horizontal marginal discrepancy on radiographic evaluation.

To determine the accuracy and false negative rate of axillary ultrasound compared to sentinel node biopsy.

The retrospective study was conducted at the Aga Khan University Hospital, Karachi, from February 1 to March 31, 2021, and comprised data of breast cancer patients who had undergone neo-adjuvant chemotherapy followed by axillary lymph node dissection or axillary disease diagnosed using lymph node biopsy or sentinel lymph node biopsy between January 1, 2016, and December 30, 2020. After receiving neoadjuvant chemotherapy, axillary ultrasound findings were compared with histopathology of lymph nodes. Data was analysed using SPSS 22.

Of the 155 patients evaluated, 104(67.1%) were diagnosed with negative axillary lymph nodes and 51(32.9%) were diagnosed with positive axillary lymph nodes post-chemotherapy. The overall mean age was 51.13±1.3 years. When histopathology results were compared with those of axillary ultrasound, 36(23.2%) cases turned out to be true positive, while 23(14,8%) were false negative, yielding a positive predictive value of 75% and negative predictive value of 65%. Axillary ultrasound had 75% accuracy, false negative rate 30%, sensitivity 61% and specificity 84.4%.

Axillary ultrasound was found to be fairly useful, but not completely reliable, in identifying positive lymph nodes.

Axillary ultrasound was found to be fairly useful, but not completely reliable, in identifying positive lymph nodes.

To analyse the social dissemination of publications by fulltime faculty at a tertiary care facility.

The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised publication records of the fulltime Operative Dentistry faculty members between July 2011 till July 2021. The search was done on Google Scholar, Altmetric Explorer and PubMed electronic databases. After final screening, all the publications in PubMed-indexed journals, including in vitro studies, randomised controlled trials, original research articles, case reports and letters to the editor, for which the Altmetric Attention Score was available were included.

Of the 225 publications identified, 34 (15%) formed the final sample. The cumulative citation count for the publications was 617 and Altmetric Attention Score was 158. There were 16 Facebook mentions and 163 tweets.

The social impact of publications by the Operative Dentistry faculty over a decade was not convincing in terms of Altmetric Attention Score.

The social impact of publications by the Operative Dentistry faculty over a decade was not convincing in terms of Altmetric Attention Score.

To identify factors that influence the choice of specialty of dentistry postgraduate residents in an urban setting.

The cross-sectional analytical study was conducted from April to May 2020 at health centres approved for the Fellowship of the College of Physicians and Surgeons training in Karachi, and comprised dental postgraduate residents. Data was collected using a questionnaire distributed using Google Forms. Residents were asked to rate factors that influenced their decision to join their clinical specialty on a 3-point Likert scale. Items were based on the basis of anticipated clinical experiences, specialty-specific factors, personal preferences, and possible constraints. Data was analysed using SPSS 23.

Of the 51 subjects, 39(76.5%) were females and 12(23.5%) were males. The overall mean age was 27.7±2.17 years. Besides, 27(52.9%) subjects were from public-sector centres and 24(47.1%) from private-sector centres. Of all the residents, 44(86.3%) chose their specialty because of inclination to treat complex cases, while 43(84.3%) were interested because of the broad range of cases, and 39(76.5%) made their choice because of the reputation of the respective supervisors and institutions. Also, 43(84.3%) residents did not consider the expiry of their fellowship part one exam deadline, or unavailability of a training slot as a specific reason to select a specialty. Compared to males, significantly more females opted for a specialty if it eventually provided career opportunity as faculty (p<0.05).

Factors that greatly influenced the residents' choice for postgraduate training specialty were related to anticipated clinical experiences.

Factors that greatly influenced the residents' choice for postgraduate training specialty were related to anticipated clinical experiences.

To determine the frequency of Temporary epicardial pacing wires usage and its predictors in the immediate postoperative period in isolated coronary artery bypass graft surgery.

The longitudinal study was conducted at the Aga Khan University Hospital, Karachi, from September 2019 to August 2020, and comprised adult patients of either gender who underwent isolated coronary artery bypass graft in the Department of Cardiothoracic Surgery. Demographic, peri-operative and post-operative Temporary Epicardial Pacing Wires use data was extracted from patient's files and the institutional electronic database. Logistic regression models were built to explore predictors of Temporary epicardial pacing wires usage. Data was analysed using SPSS 22.

Of the 322 cases evaluated, 27(8.4%) required the use of Temporary Epicardial Pacing Wires. Mean age of the patients requiring temporary epicardial pacing wires was 66.3±8.9 years compared to 58.7±8.9 years in those who did not require it (p<0.001), while the left ventricular ejection fraction percentage was 44.1±12.8 and 48.9±12.8 respectively (p=0.032). After adjusting for clinically plausible demographics and peri-operative variables, increasing age and low left ventricular ejection fraction were significantly associated with the use of temporary epicardial pacing wires in post-operative period of isolated coronary artery bypass graft patients (p<0.05).

The frequency of temporary epicardial pacing wires usage in the post-operative period of coronary artery bypass graft was found to be low.

The frequency of temporary epicardial pacing wires usage in the post-operative period of coronary artery bypass graft was found to be low.

To determine the incidence of complications [Surgical site infection (SSI), intra-abdominal abscess (IAA), stump leak] related to stump ligation with manual loop of sliding extracorporeal suture knot in laparoscopic appendectomy.

This cohort study was conducted on patients who underwent laparoscopic appendectomy from June 2014 to November 2020 performed by the same surgeon with almost similar technique. Stump was ligated with manual loops, applied by the surgeon or trainee or both (one by surgeon and other by trainee). SSI and IAA were classified according to Centers for Disease Control and Prevention (CDC) criteria.

Total 120 patients were included with median (Interquartile range, IQR) age of 24 (19-35) years and male predominance i.e. 81 (67.5%). Median (IQR) for the duration of symptoms, time from presentation to surgery and duration of surgery was 2(1-4) days, 10 (4-15) hours and 60 (44-70) minutes, respectively. SSI was documented in 9(7.5%) patients, managed by wound hygiene and antibiotics. IAA was observed in one(0.8%) patient who required readmission for antibiotics and radiology guided drain placement. No stump leak was observed.

Manual endo-loop is a safe, reliable and cost effective technique for stump ligation in LA, and can safely be incorporated into teaching of surgical trainees.

Manual endo-loop is a safe, reliable and cost effective technique for stump ligation in LA, and can safely be incorporated into teaching of surgical trainees.

To compare one year retention rate of bonded amalgam sealants (BAS) with that of conventional resin-based sealant (RBS).

It was a parallel group, equivalence, randomised controlled trial done during March 2018 to December 2019 at the dental clinics of Dow University of Health Sciences, and the Jinnah Sind Medical University, Karachi, Pakistan on children aged 12-16 years, who were randomly assigned to one of the two treatment groups (BAS vs. RBS). Complete retention of the sealant at one year follow-up was labeled as success. Multi-level mixed effect logistic regression model was employed. Study was registered at www.clinicaltrials.gov # NCT NCT03130725.

There were 137 teeth (23 subjects) in the BAS and 128 teeth (15 subjects) in the RBS group that were evaluated for sealant retention at 12 months follow-up. AGI-24512 datasheet Among the BAS group, 100/137 (73%) sealants were completely retained whereas 110/128 (86%) were fully retained in the RBS group. Nearly, 22/137 (16%) BAS and 10/128 (7.8%) RBS were completely dislodged. In multivariable analysis, subject age >15 years and male gender were found to be significantly associated with the dislodgement of sealants.

At 12 months follow-up, the retention of bonded amalgam sealant (BAS) was significantly lower than that of the resin-based sealant (RBS).

www.clinicaltrials.gov with # NCT NCT03130725.

www.clinicaltrials.gov with # NCT NCT03130725.Mental health encompasses a range of mental, emotional, social, and behavioral functioning and occurs along a continuum from good to poor. Previous research has documented that mental health among children and adolescents is associated with immediate and long-term physical health and chronic disease, health risk behaviors, social relationships, education, and employment. Public health surveillance of children's mental health can be used to monitor trends in prevalence across populations, increase knowledge about demographic and geographic differences, and support decision-making about prevention and intervention. Numerous federal data systems collect data on various indicators of children's mental health, particularly mental disorders. The 2013-2019 data from these data systems show that mental disorders begin in early childhood and affect children with a range of sociodemographic characteristics. During this period, the most prevalent disorders diagnosed among U.S. children and adolescents aged 3-17 years weildren's mental health exists and no single indicator can be used to define the mental health of children or to identify the overall number of children with mental disorders, these data confirm that mental disorders among children continue to be a substantial public health concern. These findings can be used by public health professionals, health care providers, state health officials, policymakers, and educators to understand the prevalence of specific mental disorders and other indicators of mental health and the challenges related to mental health surveillance.In 2021, a national emergency* for children's mental health was declared by several pediatric health organizations, and the U.S. Surgeon General released an advisory† on mental health among youths. These actions resulted from ongoing concerns about children's mental health in the United States, which was exacerbated by the COVID-19 pandemic (1,2). During March-October 2020, among all emergency department (ED) visits, the proportion of mental health-related visits increased by 24% among U.S. children aged 5-11 years and 31% among adolescents aged 12-17 years, compared with 2019 (2). CDC examined changes in U.S. pediatric ED visits for overall mental health conditions (MHCs) and ED visits associated with specific MHCs (depression; anxiety; disruptive behavioral and impulse-control disorders; attention-deficit/hyperactivity disorder; trauma and stressor-related disorders; bipolar disorders; eating disorders; tic disorders; and obsessive-compulsive disorders [OCD]) during 2019 through January 2022 among children and adolescents aged 0-17 years, overall and by sex and age.

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