Evaluation of parental awareness regarding their child's oral hygiene

OBJECTIVES

To determine parental awareness about their child's oral hygiene and its associated factors.

METHODS

In this cross-sectional study, 396 parents and their 3- to 6-year-old children were selected by randomized cluster sampling from Shiraz kindergartens in 2013. Parents completed a questionnaire on their perception of their child's oral hygiene. The children received a dental examination, and their dental cleaning status was determined using Simplified Debris Index. Parental awareness was determined by comparing parents' perception of their child's oral hygiene with the results of the dental examination. Associations between demographic factors and parental awareness were evaluated.

RESULTS

Sixty per cent of the parents were aware of their child's teeth cleaning status. Higher percentage of parents with university degree (P < 0.001) and parents whose child did not have a previous dental visit (P < 0.001) were aware. Also, more aware mothers were employed compared with homemakers (P = 0.002). Children of aware parents had lower dmft (P < 0.001) and better oral hygiene (P = 0.001) than those of unaware parents. Parents who perceived overall oral health status of their child as good (P < 0.001) as well as those who believed that their child did not have any cavities (P < 0.001) were more likely to be aware of their child's teeth cleaning than those who perceived otherwise.

CONCLUSION

Many parents were not aware of their child's oral hygiene. Educational interventions should be provided to young families to increase parental knowledge and skills that help them recognize their child's dental needs. The interventions are more necessary for low socioeconomic parents and for the parents of children with poor oral hygiene.

A 47 Years Lady with Intrathoracic Lipoma

A case of a 47 years old female who presented to Mymensingh Medical College Hospital, Medicine Unit-5, complaining of severe dyspnea and occasional leg swelling. Chest X-ray, USG of chest and chest CT scan revealed a right sided giant intrathoracic mass extending across the posterior mediastinum into the left chest cavity. CT guided FNAC of right lung revealed lipoma.

Regulation and involvement of matrix metalloproteinases in vascular diseases

Matrix metalloproteinases (MMPs) are a family of zinc dependent endopeptidases whose main function is to degrade and deposit structural proteins within the extracellular matrix (ECM). A dysregulation of MMPs is linked to vascular diseases. MMPs are classified into collagenases, gelatinases, membrane-type, metalloelastase, stromelysins, matrilysins, enamelysins, and unclassified subgroups. The production of MMPs is stimulated by factors such as oxidative stress, growth factors and inflammation which lead to its up- or down-regulation with subsequent ECM remodeling. Normally, excess activation of MMPs is controlled by their endogenous inhibitors, tissue inhibitors of metalloproteinases (TIMPs). An imbalance of MMPs and TIMPs has been implicated in hypertension, atherosclerotic plaque formation and instability, aortic aneurysms and varicose vein wall remodeling. Also, recent evidence suggests epigenetic regulation of some MMPs in angiogenesis and atherosclerosis. Over the years, pharmacological inhibitors of MMPs have been used to modify or prevent the development of the disease with some success. In this review, we discuss recent advances in MMP biology, and their involvement in the manifestation of vascular disease.

FESS, fingers and other things--you are not alone!

BACKGROUND

The objectives of the study were: firstly, to determine the prevalence and severity of musculoskeletal symptoms attributed to the use of endoscope or body posture during endoscopic sinus surgery (ESS) among members of the British Rhinological Society (BRS); and secondly, to review the available literature and highlight posture recommendations during ESS.

METHODOLOGY

The study design consisted of a cross-sectional survey carried out among members of the BRS. The survey was distributed electronically and data was collected for statistical analysis.

RESULTS

A total of 82 members responded to the questionnaire (22.4%); 78 respondents (94%) answered the main questions in the survey regarding the symptoms attributed to the use of endoscope or body posture during ESS. Fifty-three respondents (64%) completed all 19 questions. 58% and 59% of the 78 respondents reported suffering from pain and stiffness respectively. We found positive correlations between musculoskeletal symptoms and operating in the standing position and musculoskeletal symptoms and age.

CONCLUSION

This survey reveals a high prevalence of musculoskeletal symptoms, attributed to ESS and body posture during surgery, among the British rhinologists who responded to the survey. ESS is evidently physically demanding on the surgeon with potential personal health hazards. This emphasizes the need to increase awareness among surgeons, familiarize ourselves with good operating posture habits and new ergonomic instruments and to create a drive to change operating theatre culture in an attempt to reduce these health risks.

Abstract P023: Toll-like Receptor 4 Deficiency Reduces Macrophage Mediated Renal Injury in Ang-II Induced Hypertension

Infiltration of macrophages has been amply demonstrated in the kidney of humans and experimental models of hypertension however, its role in tissue injury and repair remains unclear. Furthermore, recent studies implicate upregulation of toll-like receptor 4 (TLR4) and inflammation in hypertension and vascular remodeling. Previously, we observed that C3H/HeJ mice lacking functional TLR4 were hyporesponsive to Ang-II induced hypertension and renal damage. In this study, we hypothesized that TLR4 deficiency inhibits macrophage mediated inflammation and TGF-β-induced fibroblast accumulation to reduce renovascular injury and fibrosis. Male C3H/HeOuJ (functional TLR4) and C3H/HeJ mice (dysfunctional TLR4) aged 8-10 weeks underwent subcutaneous osmotic pump insertion for infusion of Angiotensin-II (Ang-II) at 1000 ng/kg/min or vehicle (0.9% saline) for 4 weeks. Blood pressure (BP) was measured twice weekly by non-invasive tail-cuff plethysmography. Ang-II treatment increased mean BP in both groups but to a greater degree in C3H/HeOuJ mice compared to C3H/HeJ (138.6± 6.3 vs. 103.4±7.2 mm/Hg). Plasma creatinine in saline treated C3H/HeOuJ and C3H/HeJ mice was normal (0.37±0.026 and 0.32±0.023 mg/dL respectively) in contrast to ang-II treated mice (1.34±0.075 vs. 0.78±0.052 mg/dL). Flow cytometry revealed increased F4/80+ and CD40+ cells indicating pro-inflammatory M1 macrophage in Ang-II treated C3H/HeOuJ compared to C3H/HeJ mice. Similarly, Ang-II increased the mRNA and protein expression of CD40, MCP-1, TNF-α and TGF-β in C3H/HeOuJ compared to C3H/HeJ mice. Immunostaining revealed increased colocalization of CD45 and procollagen-1 in renal sections of C3H/HeOuJ mice suggesting increased accumulation of myeloid fibroblasts than in C3H/HeJ mice. The expression of α-smooth muscle actin an indicator of myofibroblast and extracellular matrix proteins, collagen type I and fibronectin (Western blot and immunostaining) was increased in C3H/HeOuJ compared to C3H/HeJ mice. In conclusion, our data suggests that in C3H/HeJ mice, deficiency of functional TLR4 reduces macrophage activation and inflammation which in turn decreases TGF-β-induced renal fibrotic response in Ang-II induced hypertension.

Abstract P016: GYY4137, a Hydrogen Sulfide Donor, Mitigates Ang II-induced Extracellular Matrix Remodeling in Glomerular Endothelial and Mesangial Cells

Hypertensive nephropathy is associated with progressive alteration of extracellular matrix (ECM) components. Both mesangial and glomerular endothelial cells have the ability to synthesize and degrade ECM proteins such as collagens by changes in the activity of matrix metalloproteinases (MMPs) and their inhibitors, tissue inhibitors of metalloproteinases (TIMPs). Endo180 is an extracellular fibronectin type II domain involved in lysosomal degradation of collagen which has been shown to mitigate renal fibrosis. More recently, hydrogen sulfide (H2S) has also been shown to mitigate hypertensive renal remodeling, however, its mechanism remains unclear. In this study, our aim was to investigate whether Angiotensin-II (Ang II) treatment alters the expression of Endo180, MMPs and TIMPs leading to dysregulation of collagen metabolism and whether GYY4137 (H2S donor) restores their levels to achieve homeostasis. Mesangial and mouse glomerular endothelial cells (MCs and MGECs respectively) were treated without or with Ang II (200 nM) and GYY4137 (250 μM) for 48hrs. Cell lysates were analyzed for MMP-13, -14, TIMP-1, Endo180, and collagen IV by Western blot, RT-PCR, and immunohistochemistry. In MGECs, Ang II treatment compared to its control decreased MMP-13/TIMP-1 ratio (0.75±0.44 vs. 2.48 ±0.73), and upregulated MMP-14/TIMP-1 ratio (0.64±2.10 vs. 0.96±1.47), and collagen IV (0.77±0.07 vs. 0.58±0.06). GYY4137 treatment mitigated these changes. In contrast, Ang II treatment in MCs decreased Endo180 compared to control (0.72±0.04 vs. 1.07±0.23), but did not alter the expression of MMP-13/TIMP-1, MMP-14/TIMP-1 ratios, and collagen IV level compared to control or MGECs. Similarly, immunostaining showed downregulation of MMP-13 and Endo180 in Ang II treated MGECs which was normalized following GYY4137 treatment. Endo180 was also normalized in MCs following GYY4137 treatment however, there was no change in MMP-14/TIMP-1 ratio or collagen IV level. We conclude that Ang II treatment causes adverse ECM remodeling in MGECs via downregulation of Endo180 and MMP-13 and upregulation of MMP-14 and TIMP-1 and in MCs by decreasing Endo180, and GYY4137 mitigates these changes in part, by modulating Endo180/MMP/TIMP pathway.

Evaluation of DNA extraction methods for the detection of Cytomegalovirus in dried blood spots

BACKGROUND

Dried blood spots (DBS) are collected universally from newborns and may be valuable for the diagnosis of congenital Cytomegalovirus (CMV) infection. The reported analytical sensitivity for DBS testing compared to urine or saliva varies greatly across CMV studies. The purpose of this study was to directly compare the performance of various DNA extraction methods for identification of CMV in DBS including those used most often in CMV studies.

STUDY DESIGN

Whatman(®) Grade 903 filter paper cards were spotted with blood samples from 25 organ transplant recipients who had confirmed CMV viremia. Six DNA extraction methods were compared for relative yield of viral and cellular DNA: 2 manual solution-based methods (Gentra Puregene, thermal shock), 2 manual silica column-based methods (QIAamp DNA Mini, QIAamp DNA Investigator), and 2 automated methods (M48 MagAttract Mini, QIAcube Investigator). DBS extractions were performed in triplicate followed by real-time quantitative PCR (qPCR).

RESULTS

For extraction of both viral and cellular DNA, two methods (QIAamp DNA Investigator and thermal shock) consistently gave the highest yields, and two methods (M48 MagAttract Mini and QIAamp DNA Mini) consistently gave the lowest yields. There was an average 3-fold difference in DNA yield between the highest and lowest yield methods.

CONCLUSION

The choice of DNA extraction method is a major factor in the ability to detect low levels of CMV in DBS and can largely account for the wide range of DBS sensitivities reported in studies to date.

Impact of oral hygiene on oral health-related quality of life of preschool children

OBJECTIVES

To assess the impact of oral hygiene of preschool children and parental attitude on children's oral health-related quality of life (OHRQoL).

METHODS

In this cross-sectional study, 396 children of Shiraz kindergartens were selected by a randomized cluster sampling. Children's oral hygiene was assessed using the Simplified Debris Index (DI-S) and a self-made questionnaire about oral hygiene habits. Children's OHRQoL was evaluated by the Farsi version of Early Childhood Oral Health Impact Scale (F-ECOHIS). The effect of oral hygiene determinants on OHRQoL was measured using Pearson and Spearman correlation, independent-sample t-test and anova.

RESULTS

Children's mean DI-S and F-ECOHIS scores were 1.19 (± 0.77) and 19.36 (±8.42), respectively. Only 75% of the children had their teeth brushed once a day or more, and in 28%, toothbrushing had started before 2 years of age. DI-S values (P < 0.001) and frequency of toothbrushing (P < 0.001) had a statistically significant impact on OHRQoL of the children. Children's OHRQoL was also significantly associated with parents' attitude towards the importance of brushing deciduous teeth (P = 0.002).

CONCLUSIONS

Oral health status of preschool children in Shiraz was less than optimal and had a significant impact on their OHRQoL. Therefore, improvement of children's OHRQoL could be achieved by improving their home dental care. Strategies promoting parental attitude about the importance of children's toothbrushing may significantly influence children's oral hygiene and are highly recommended.

Profile of PRMT-1 gene polymorphism in hemodialysis patients with increased ADMA levels

AIM

to determine the distribution of PRMT-1 gene polymorphism and ADMA levels among continuing hemodialysis patients.

METHODS

genotyping of PRMT-1 polymorphism was performed in 57 hemodialysis patients at Al Irsjad Hospital. All participants were recruited for physical examination, questionnaire, and collection of 5 mL fasting venous blood. The blood was treated with phenol-chloroform extraction of genomic DNA. The candidate's single nucleotide polymorphisms (SNPs) were genotyped by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The ADMA plasma levels was determined by ELISA and all biochemical indicators of serum were examined.

RESULTS

fifty-seven hemodialysis patients participated in our study, 54 (95.4%) of them had increased ADMA plasma levels. DNA sequencing analysis of 13 patients showed a suspected PRMT-1 gene polymorphism at sequence 5837 as there were different genotypes between C and G.

CONCLUSION

the increased levels of ADMA might be caused by PRMT-1 gene polymorphism.