Robot-assisted laparoscopic partial nephrectomy (RALPN) has increasingly emerged as a primary minimally invasive surgical approach for managing renal masses. In China, most urologic surgeons lack experience in transperitoneal laparoscopic partial nephrectomy, and limited research exists on the learning curve for transperitoneal RALPN. This study applies cumulative sum (CUSUM) analysis to evaluate the learning curve, providing clinical suggestions. We recruited patients who underwent transperitoneal RALPN performed by a single surgeon between March 2017 and December 2023. The learning curve was evaluated using CUSUM analysis of operative time (OT). The curve’s peak was used as the cutoff point to stratify patients for comparative analysis of clinical characteristics and perioperative outcomes. In addition, multivariate linear regression analysis was used to identify potential factors influencing OT. 119 patients were enrolled. The curve peaked at the 38th case and subsequently declined, dividing the patients into two groups: the learning phase (38 cases) and the mastery phase (81 cases). OT (115 vs. 150 min., P < 0.001), WIT (19 vs. 24 min., P < 0.001), and hospital stay (6 vs. 7 days, P = 0.005) were lower in the mastery phase. Tumor size (P = 0.027) and surgeon experience (P < 0.001) were identified as potential risk factors for OT. This study demonstrates that the learning curve for transperitoneal RALPN is relatively short. Comparative analysis of perioperative outcomes revealed superior outcomes during the mastery phase. These findings may serve as a benchmark for urologic surgeons’ skill acquisition.
This study aimed to elucidate the most recent evidence regarding complications, perioperative outcomes, and pathological results associated with extracorporeal urinary diversion (ECUD) in comparison to intracorporeal urinary diversion (ICUD) during robotic-assisted radical cystectomy (RARC). A systematic review and meta-analysis were conducted to facilitate this comparison. We conducted a thorough systematic review of relevant studies by systematically searching several databases, including PubMed, Embase, Cochrane Library, and Web of Science, to assess the implications of ICUD versus ECUD in the context of RARC. The examination of binary variables employed relative risk (RR) measurements, whereas weighted mean differences (WMD) served as the primary metric for evaluating continuous variable outcomes. Twenty-two studies involving 8030 patients were included, of which 3755 received ICUD and 4278 received ECUD. Baseline characteristics were similar in the two cohorts. The study showed that the ICUD cohort had a notably lower rate of severe complications in the late phase (30–90 day) [RR = 0.71, 95
Background:Persistent endodontic infections, often attributed to Enterococcus faecalis, pose a significant challenge to successful root canal treatment. Conventional disinfection methods have limitations in eradicating bacteria within complex root canal anatomy. Nanoparticles (NPs) have evolved as favorable antibacterial agents due to their distinctive properties. Aim:To compare the antimicrobial activity of ZnO and MgO NPs (nanorods and nanospheres) with 3% sodium hypochlorite (NaOCl) against E. faecalis (American-type culture collection [ATCC] 29212 and a clinical oral isolate) using agar well diffusion, minimum inhibitory concentration (MIC), and time-kill assays. Methods:ZnO and MgO NPs (nanorods and nanospheres) were synthesized and characterized using ultraviolet-visible (UV-visible) spectrophotometry to determine the optical properties of materials and transmission electron microscopy for measuring nanoparticle size, distribution, morphology, and grain size. Agar well diffusion was used to measure antimicrobial activity at various volumes (50-150 mu L). MIC was calculated using the broth microdilution method. Time-kill assays were performed by quantifying colony-forming units at 15 min intervals for 90 min. One-way analysis of variance with Tukey's post hoc test (P < 0.05) was used for statistical analysis. Results:The peak acquired for ZnO nanorods was 360 nm, ZnO nanosphere was 350 nm, MgO nanorods were 250 nm, and MgO nanosphere was 270 nm in UV-visible spectrophotometry. The transmission electron microscope confirmed an average NP size of 20 nm for all morphologies. In the agar well diffusion assay, ZnO nanorods exhibited better activity than other NPs except for 3% NaOCl against both E. faecalis strains at all volumes (75-150 L) (P = 0.001). MgO nanorods also demonstrated significant activity, although generally at higher volumes (150 mu L) than ZnO (P = 0.001) and MgO (P = 0.002) nanospheres. The MIC values (mg/mL) against the ATCC strain were as follows: MgO-S (1.17), MgO-R (18.75), ZnO-R (18.75), and ZnO-S (37.5). Against the clinical isolate, the MIC values were as follows: MgO-R (18.5), MgO-S (18.5), ZnO-R (37.5), and ZnO-S (75). In the time-kill assay, all NPs, except MgO nanorods against the ATCC strain (effective at 30 min), achieved rapid bactericidal activity within 15 min, comparable to 3% NaOCl. Conclusion:Both ZnO and MgO NPs, particularly ZnO nanorods, demonstrated promising antimicrobial activity against E. faecalis in vitro, comparable to 3% NaOCl in certain assays. ZnO NPs of various shapes have distinct active facets that increase their antimicrobial action such as rods and wires that have more facets than spherical NPs. ZnO nanorods penetrate easily into the cell walls of bacteria than nanosphere. Additionally, ZnO nanorod and sphere release more reactive oxygen species (ROS) that interacts with proteins, resulting in bacterial cell lysis. The main mechanism of action of MgO NPs (nanorod and nanosphere) is the formation of ROS that interacts with the proteins peptide linkages in microorganisms, ultimately resulting in cell death. These results highlight the potential of these NPs in endodontic disinfection, such as incorporation into sealers or gutta-percha coatings. Future research should focus on evaluating their biocompatibility and long-term efficacy in biofilm models.
In pediatric dentistry, antibiotics are crucial for controlling oral infections and preventing their spread. However, concerns about overuse and inappropriate prescriptions persist. Understanding the complexities of antimicrobial use is vital for optimal oral health outcomes, particularly due to the unique physiology and compliance issues in young patients. This narrative review comprehensively searched peer-reviewed literature, guidelines, and systematic reviews from databases involving PUBMED, Cochrane Library, Google Scholar, Trip Database, Lilacs, ProQuest, and Wiley Library, using keywords related to adverse effects, infection control, pediatric dentistry, and antibiotic use. No publication year restrictions were applied, and references from key papers were reviewed for additional relevant research. Results indicate that while antibiotics can effectively treat bacterial infections in pediatric patients, misuse can lead to adverse outcomes like antimicrobial resistance. Special considerations in pediatric dentistry necessitate tailored antibiotic administration approaches. Adhering to evidence-based guidelines and exercising sound clinical judgment are essential to mitigate the risks of antibiotic overuse. Comprehensive education for dental professionals, caregivers, and young patients is crucial to promote responsible antimicrobial practices and enhance oral health outcomes. A well-rounded strategy for antibiotic use in pediatric dentistry is key to achieving optimal dental health results while minimizing associated risks.
Introduction: Compulsive Buying Disorder (CBD), also known as buying shopping disorder or Oniomania, is a growing concern that affects mental health, relationships, and financial stability. It is characterised by excessive and uncontrollable buying behaviour. With the rise of consumerism and the proliferation of online shopping, compulsive buying has increased, particularly among adolescents and young adults. Aim: To estimate the prevalence of CBD and identify associated risk factors among undergraduate medical, dental, and nursing students. Materials and Methods: A cross-sectional study was conducted in the Chengalpattu district of Tamil Nadu, India from November 2023 to March 2024 among undergraduate students from six colleges. A total of 380 students from medical, dental, and nursing disciplines participated in the study. A pretested semistructured questionnaire was used to collect information on socio-demographic details and various risk factors associated with CBD. The validated Richmond Compulsive Buying Scale (RCBS) was employed to determine the prevalence of CBD. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 22.0. Results: Among the participants, 232 (61.1%) were female, and 148 (38.9%) were male, with the majority, 272 (71.6%), being under 21 years of age. Educationally, 201 (55.3%) were medical students, while 85 (22.4%) were from nursing and dental disciplines. CBD was observed in 113 (29.7%) of the participants. Significant associations with CBD included female gender, medical education, family history of shopaholics, online shopping, shopping-induced euphoria, anxiety or distress when unable to shop, and lying to family or friends about shopping expenses (p-value <0.05). Conclusion: The study revealed that 29.7% of undergraduate students exhibited Compulsive Buying Behaviour (CBB). These findings underscore the importance of targeted interventions and awareness campaigns that address identified risk factors, such as gender, academic discipline, family history, and emotional triggers related to shopping. Such efforts could enhance mental health, financial stability, and interpersonal relationships among students.
