Abstract Introduction: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) refer to episodes characterised by a deterioration of symptoms, which can lead to significant disease advancement, increased hospital admissions and higher mortality rates. Although detailed clinical assessments and biochemical markers can enhance early risk stratification, they are often underused in standard tertiary care environments. Materials and Methods: This cross-sectional study involved 100 patients admitted to a tertiary care facility due to AECOPD over 18 months. Data on demographics, clinical information, electrocardiogram results and biochemical metrics – including N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and eosinophil count – were collected and analysed. Outcomes were defined as either recovery or in-hospital mortality. Results: The average age of participants was 61.6 years (±13.3), with 57% of them being male. There was a notable connection between elevated NT-proBNP levels and a much higher mortality rate, observed at 55% compared to just 6.2%. Similar findings were noted with eosinophilia, where mortality rates were 53.8% versus 10.3%, and for P-pulmonale, which had rates of 52.9% compared to 8.4%. All these differences were statistically significant ( P < 0.001). In addition, the presence of hypertension and diabetes as comorbidities also significantly impacted mortality rates. While CRP and NLR showed moderate correlations with outcomes, these were not found to be statistically significant. Conclusion: The findings indicate that clinical severity, coexisting cardiovascular issues and specific biochemical markers can serve as independent predictors of mortality in patients with AECOPD. A thorough evaluation of these factors can enhance triage and management in tertiary care facilities.
Abstract Climate change poses significant threats to global health, and older adults are particularly vulnerable due to physiological, socioeconomic and environmental factors. Understanding the breadth of health impacts on this demographic is crucial for developing targeted interventions and policies. This scoping review aims to systematically map the existing literature on the health impacts of climate change on older adults, identify knowledge gaps and provide evidence-based policy recommendations. Following the PRISMA Extension for Scoping Reviews framework, we conducted a comprehensive search of peer-reviewed literature across multiple databases. Studies examining the relationship between climate change and health outcomes in older adults aged 60 years and above were included. Data were extracted and synthesised thematically across physical health, mental health and social well-being domains. The review identified multifaceted health impacts of climate change on older adults, including increased morbidity and mortality from extreme heat events, cardiovascular and respiratory complications from air pollution, mental health challenges associated with climate-related disasters and social isolation exacerbated by environmental changes. Significant gaps exist in research addressing the intersectionality of climate impacts with socioeconomic status, geographic location and pre-existing health conditions among older populations. Older adults face disproportionate health risks from climate change, necessitating age-inclusive climate adaptation strategies, enhanced healthcare infrastructure and policies that address both immediate and long-term vulnerabilities. Future research should focus on the effectiveness of interventions and on the development of resilience-building programmes tailored to ageing populations.
Introduction: Microleakage is the passage of bacteria, fluids and ions between a dental filling and the tooth’s cavity walls. It is a key measure of a restorative material’s success and longevity. While composite resins offer better aesthetics and properties than older materials, they can still be limited by factors like polymerisation shrinkage, which contributes to microleakage. This in vitro study aimed to comparatively evaluate coronal microleakage in Class I cavities restored with five different direct composite resins using a Confocal Laser Scanning Microscope (CLSM). Materials and Methods: To compare microleakage among five different composite resins, 100 human premolars with Class I cavities were prepared. After restoration with a specific composite and bonding agent for each of the five groups, all samples underwent thermocycling. They were then submerged in Rhodamine-B dye, sectioned and examined with a CLSM. Statistical analysis using analysis of variance, Tukey and Student’s t -tests determined significant differences. Results: Amongst the five materials, the least microleakage was observed with Tetric N-Ceram, followed by Filtek Z350 XT and Fusion Universal. Brilliant NG exhibited slightly higher microleakage, while the maximum microleakage was recorded with Neo Spectra ST, which was statistically significant with other tested groups. Conclusion: None of the tested composite resins exhibited a complete absence of microleakage. The least microleakage was observed with Tetric N-Ceram, whereas maximum microleakage was recorded with Neo Spectra ST.
Abstract Cellular homeostasis depends on mitochondria, which also play a role in triggering different diseases, such as cancer, neurodegenerative disorders and immune-related conditions. Specific anti-mitochondrial therapeutic methods represent a promising treatment strategy that allows proper control over mitochondrial processes with reduced side effects. The review examines state-of-the-art antimitochondrial therapeutic approaches through the evaluation of innovative delivery platforms, chemical treatments and genetic therapeutic methods. The review examines existing challenges and future prospects within this field. The analysis of recent publications emphasised mitochondria-sensitive metabolic routes and selective delivery systems and therapeutic progress. Research investigates four main delivery and pharmacological approaches, which consist of mitochondria-penetrating peptides and lipophilic cations and nanoparticle-based carriers in addition to emerging pharmacological agents. Modern research has substantially improved the accuracy of treatment methods that target mitochondria. Drug delivery systems development has enabled medical professionals to control mitochondrial bioenergetics, specifically create apoptosis in defective cells and manage reactive oxygen species. RNA interference, along with gene therapy, shows great promise for correcting mitochondrial gene mutations while simultaneously controlling disease-related mitochondrial proteins. Immunomodulatory approaches that combine with methods aimed at controlling mitochondrial dynamics help improve the treatment potential of these therapeutic strategies. Anti-mitochondrial pharmaceutical treatments hold promise for the medical therapy of multiple diseases. The clinical utilisation of antimitochondrial therapies encounters challenges regarding their efficiency and safety ratio. Research must persist into accurate drug delivery methods alongside mitochondrial-targeting approaches to develop clinical applications from these scientific advancements.
Inappropriate antibiotic use contributes to bacterial resistance, underscoring the need to evaluate antibiotic consumption. This study assessed trends in two government hospitals in South Kalimantan and identified antibiotics with the largest deviation between prescribed daily dose (PDD) and defined daily dose (DDD). This study is descriptive and analytical, describing and comparing antibiotic consumption in urinary tract infections (UTIs) in two hospitals. A retrospective. The study was conducted at two government hospitals in South Kalimantan. A multicenter study was conducted on adult patients with UTIs (ICD-10: N.39) at Banjarmasin Government Hospital (BGH) and Martapura Government Hospital (MGH) during 2023–2024. Antibiotic consumption was calculated using the World Health Organization (WHO) ATC/DDD index and expressed as DDD/100 patient-days. Statistical analyses included Mann–Whitney and paired sample tests. No significant difference was observed between hospitals ( P = 0.734). At BGH, consumption declined but was not significant ( P = 0.216), while MGH remained stable (85.20 vs. 84.63 DDD/100 patient-days; P = 0.946). Deviations were found for azithromycin at BGH and oral cefixime, both prescribed above the WHO standards. Consumption trends varied between hospitals, yet both showed persistent PDD–DDD deviations, indicating challenges in applying international standards due to local practice and policy differences.
Introduction: Root canal preparation is crucial for successful endodontic treatment. It involves cleaning and shaping the canal, but files can cause canal transportation, or the undesirable removal of dentin, especially in curved canals. This study aims to use cone beam computed tomography (CBCT) to compare the centring ability and transportation caused by two rotary (Hyflex EDM and ProTaper Next) and two reciprocating (WaveOne Gold and Reciproc Blue) file systems. Materials and Methods: 80 mesial roots from human mandibular molars were randomly assigned to two groups: Rotary and reciprocating file systems. Each group was further divided into two subgroups for specific files (ProTaper Next, Hyflex EDM, WaveOne Gold and Reciproc Blue). Pre- and post-instrumentation CBCT scans were taken to evaluate and compare canal centring and transportation at three different levels. Results: Canal centring ratio was significant bucco-lingually and mesio-distally at 5 mm and 7 mm levels between Groups 1a, 1b, 2a and 2b ( P < 0.05). Canal transportation was significant bucco-lingually at 3 mm, 5 mm and 7 mm levels between Groups 3a and 3b ( P < 0.05). However, mesio-distally, no statistically significant difference ( P > 0.05) was seen between the groups at all three levels of the root canal. Conclusion: Hyflex EDM rotary file showed better root canal centring ability and lesser canal transportation compared to ProTaper Next file, whereas WaveOne Gold reciprocating file showed better root canal centring ability, and the Reciproc Blue file showed lesser canal transportation at all three levels of root canals. However, the Hyflex EDM rotary file system showed better canal centring ability and less canal transportation compared to other file systems used.
Abstract Introduction: The rising global prevalence of diabetes mellitus, driven by chronic hyperglycaemia, has led to an increased burden of diabetic foot ulcers (DFUs), a major cause of morbidity and limb amputation. Among modifiable risk factors, body mass index (BMI) and glycated haemoglobin (HbA1c) are key indicators linked to the development and progression of DFUs. This study aimed to assess the correlation between DFU risk and HbA1c and BMI levels in diabetic patients. Materials and Methods: This retrospective observational study was conducted over 6 months in the general surgery department of a tertiary care hospital. Thirty-five diabetic patients with clinically diagnosed unilateral or bilateral DFUs were included. Patients with prior foot amputation, wheelchair dependence, psychiatric illness or who declined consent were excluded. Neuropathy, vasculopathy and structural abnormalities were assessed using Semmes-Weinstein monofilament, vibration perception and ankle-brachial pressure index. Multiple regression models were built for HbA1c and BMI, optimised using K-fold cross-validation. Results: Among 35 patients (28 males, 7 females; mean age 53.5 ± 12.3 years), the average diabetes duration was 8.9 ± 6.5 years, with poor glycemic control (mean HbA1c 8.7% ±2.7%). Predictive modelling showed strong correlations for HbA1c ( R ² =0.82) and BMI ( R ² =0.88), highlighting their significant association with DFU development. Conclusion: The study showed strong correlations between elevated HbA1c, BMI and DFU risk, emphasising the importance of glycaemic control and lifestyle interventions in preventing DFUs and supporting a multidisciplinary approach to diabetes care.
Abstract Introduction: Laparoscopic cholecystectomy (LC) is a common surgical procedure for gallstone disease. Despite its minimally invasive nature, post-operative pain and post-operative nausea and vomiting (PONV) remain significant concerns that affect patient recovery and satisfaction. Dexamethasone, a corticosteroid with known analgesic and antiemetic properties, may help improve post-operative outcomes. This study aimed to assess the effectiveness of a single pre-operative intravenous dose of dexamethasone in reducing post-operative pain and PONV in patients undergoing elective LC. Materials and Methods: A prospective interventional study was conducted on 96 patients with uncomplicated symptomatic cholelithiasis. Patients were randomly divided into two groups: Group A ( n = 48) received 8 mg IV dexamethasone 60 min before surgery, and Group B ( n = 48) received standard care. Post-operative pain was measured using the Visual Analogue Scale (VAS) at 6, 12, 18 and 24 h. Incidence of nausea, vomiting and the requirement for analgesics and antiemetics were also recorded. Statistical analysis was performed with significance set at P < 0.05. Results: Group A demonstrated significantly lower VAS scores at all time intervals ( P < 0.05). The incidence of nausea (14.6%) and vomiting (10.4%) was reduced compared to Group B (25% each). Fewer patients in Group A required analgesics (31.2% vs. 62.5%) and antiemetics (35.4% vs. 54.2%), with overall drug usage being lower. Conclusion: A single pre-operative dose of IV dexamethasone effectively reduces post-operative pain, PONV and medication requirements, offering a cost-effective and straightforward enhancement to recovery following LC.
Introduction: Non-prescription sale of controlled medicines is a growing public health problem, especially amongst low-middle-income countries, not helped by weak regulatory enforcement. Consequently, controlled medicines continue to be purchased without a prescription, exacerbating misuse and increasing morbidity and mortality. Currently, little is known about this in Pakistan. Therefore, this study aimed to evaluate the prevalence of non-prescription dispensing of controlled medicines in Pakistan. Materials and Methods: A multicentre, cross-sectional study using simulated clients (SC) was conducted in Lahore, Pakistan. SC visited 378 drug outlets (285 pharmacies and 93 medical stores) to purchase controlled medicines without providing a prescription. Data about dispensing, interactions and grounds for refusal were acquired. Results: About 61.9% of outlets dispensed controlled medicines without a prescription. The most commonly dispensed controlled medicines were tramadol (29.5%), followed by codeine (26.1%) and alprazolam (23.1%). There was no significant difference in non-prescription dispensing between pharmacies and medical stores. However, outlets lacking licenced personnel were significantly more likely to dispense controlled drugs without a prescription ( P = 0.049). Refusals were mainly due to prescription requirements (55.6%) or product unavailability (44.4%). Conclusions: There was appreciable dispensing of controlled medicines without a prescription, greater when licenced personnel were not present. Enhanced regulatory enforcement and increased presence of certified personnel are necessary going forward.
Type 2 diabetes mellitus (T2DM) is a major public health challenge and is increasingly associated with an imbalance in gut microbiota composition. Recent advances in chrononutrition, which focus on synchronising meal timing with the body’s internal biological clock (circadian rhythm), have gained attention as a potential modifiable factor of host metabolism and gut microbial diversity. Nonetheless, whether chrononutrition, circadian rhythm biomarkers, gut microbiota and cardiometabolic outcomes are associated, specifically in T2DM, remains fragmented. Therefore, we aim to conduct a systematic review of studies that evaluated the effects of chrononutrition-related dietary patterns on circadian rhythm biomarkers, gut microbial diversity and cardiometabolic outcomes in T2DM. We have structured the protocol following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 guidelines. Search of relevant studies will be executed using four databases, such as PubMed, EMBASE, Web of Science and the Cochrane Library, which involve records from their respective inception up to February 2026. The eligibility criteria for the population are adults with T2DM or rodent models of diabetes, whereas chrononutrition-related interventions include eating windows, breakfast skipping, nocturnal and evening eating. Primary outcomes are circadian rhythm biomarkers, composition and diversity of gut microbiota and cardiometabolic parameters. We will use validated tools tailored to each study design to assess methodological quality and risk of bias in the studies. Results will be integrated narratively, followed by meta-analysis where appropriate. Registration: INPLASY; Registration ID: INPLASY2025110030.
Introduction: Successful implant placement in the anterior maxilla requires detailed assessment of anatomical structures, particularly the nasopalatine canal (NPC), due to its proximity to planned implant sites. This study evaluated the anatomy and morphology of the NPC and anterior maxillary bone using cone-beam computed tomography (CBCT) to guide immediate implant planning. Materials and Methods: A cross-sectional observational study was conducted using 60 CBCT scans retrospectively selected from dentate individuals. Measurements included anteroposterior (A-P) and mediolateral (M-L) dimensions of the nasal foramen, incisive canal (IC) and incisive foramen; canal length and location; anterior maxillary bone thickness (MBT) at multiple levels; shape, angle, curvature and type of the IC; and NPC proximity to maxillary central incisor roots. Intergroup comparisons were analysed using nonparametric tests, and correlations were assessed with Spearman’s analysis. Results: Males showed significantly longer NPCs and greater horizontal MBT compared to females (P < 0.05). NPC length and MBT decreased significantly with age (P < 0.05), while vertical bone height remained stable. The IC most commonly exhibited a funnel shape (70%). No significant gender or age differences were observed in IC shape. A slight but non-significant positive correlation was noted between mean MBT and IF location. Conclusion: Anatomical variability of the NPC and anterior maxillary bone is influenced by gender and age, with important clinical implications for implant placement. Preoperative CBCT evaluation is critical to optimise implant positioning, improve primary stability and minimise neurovascular complications, particularly in female and younger patients.
Introduction: Periodontitis, a chronic inflammatory disease caused by polymicrobial biofilms, leads to tissue destruction, tooth loss and systemic health implications. Conventional therapies such as chlorhexidine have limitations, prompting a search for safer alternatives. Plant-derived agents, specifically Psidium guajava (guava) and Glycyrrhiza glabra (mulethi), are promising due to their antimicrobial, anti-inflammatory and antioxidant properties. This study aimed to compare the clinical efficacy of guava and mulethi extracts in periodontal therapy. Materials and Methods: A 9-month randomised controlled trial included sixty Localised Aggressive Periodontitis patients (18–50 years). After ethical clearance and consent, patients were diagnosed based on clinical and radiographic signs. Participants were randomised into two groups (n = 30 each): Group A (Mulethi gel) and Group B (Guava leaf extract). Gels were applied twice daily for 6 months, alongside standard oral hygiene. Clinical indices, in Plaque Index, Gingival Index and Probing Pocket Depth were assessed at baseline, 3 and 6 months by a blinded evaluator. Data were analysed using SPSS version 20; paired and independent t-tests with P < 0.05. Results: Both extracts significantly improved periodontal parameters and showed strong antibacterial activity against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans (P < 0.0001). Guava improved the mean zone of inhibition for P. gingivalis from 8.65 mm to 10.2 mm and for A. actinomycetemcomitans from 20.36 mm to 23.08 mm. Mulethi showed an increase from 9.87 mm to 11.23 mm for P. gingivalis, and from 23.11 mm to 25.07 mm for A. actinomycetemcomitans. Conclusion: Mulethi and Guava leaf extracts significantly improved gingival health and demonstrated strong antibacterial activity against key periodontal pathogens. These findings highlight their potential as effective, biocompatible alternatives in periodontal therapy, offering comparable benefits to conventional treatments with fewer side effects.
Introduction: Functional bowel disorders (FBDs) amongst shift workers are more often associated with increased stress levels and disrupted sleep. Disturbance of circadian rhythm amongst shift workers may exacerbate the symptoms, but objective contrasts amongst patients with and without FBD are scarce. Abnormal function of the gut–brain axis, elevated visceral sensitivity and disturbances in gut microbiota are also implicated in FBD pathophysiology. Understanding these mechanisms is important for the design of effective, targeted management plans for the affected individuals. Materials and Methods: A cross-sectional study was carried out in 114 shift workers at a tertiary care facility. Two groups were formed based on the participants: shift workers with FBDs (n = 57) and shift workers without FBDs (n = 57). Stress was measured by the Perceived Stress Scale-14 (PSS-14) and sleep quality by the Pittsburgh Sleep Quality Index (PSQI). Statistical differences between the groups were compared. Results: Shift workers with FBDs reported significantly higher stress levels (PSS-14 mean score: 37.26 ± 7.28) compared to those without FBDs (25.54 ± 4.94, P < 0.001). Similarly, sleep quality was poorer amongst those with FBDs (PSQI mean score: 8.54 ± 4.64) compared to those without (3.51 ± 1.64, P < 0.001). Conclusion: Shift workers with FBDs reported significantly more stress and worse quality of sleep compared to their FBD-free counterparts. Interventions specifically targeting stress management and sleep hygiene can potentially be used to enhance outcomes in this at-risk group.
Introduction: To evaluate the salivary cytokine profiles in patients with oral potentially malignant disorders (OPMDs) and compare them to healthy controls, focusing on the levels of pro-inflammatory and anti-inflammatory cytokines, and to explore the correlation between these cytokine levels and the clinical features of OPMDs. Materials and Methods: Our study included 60 participants, of whom 30 had clinically diagnosed OPMDs, while the other 30 were healthy controls. The participants were asked to provide saliva for assessment of cytokine levels to be used for the study. In total, 5 cytokines were assessed for the study, which were tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), IL-1β, transforming growth factor-beta (TGF-β) and IL-10, and were analysed using enzyme-linked immunosorbent assay. In OPMDs, the relationship between the clinical features and the level of the cytokines was analysed using descriptive statistics, correlation and the regression analytical methods. Results: The OPMD group had statistically higher levels of TNF-α, IL-6 and IL-1β compared to the healthy controls (P < 0.05). On the other hand, OPMD group levels of TGF-β were statistically significantly lower (P < 0.01), while IL-10 levels had no statistically significant difference (P = 0.25). Positive correlation of pro-inflammatory cytokines with clinical features such as lesion size and severity was observed (P < 0.05). Changes in pro-inflammatory cytokines in relation to treatment, along with elevated TGF-β levels, suggest a plausible role of cytokines in tracking disease progress and response to therapy. Conclusions: Salivary cytokines like TNF-α, IL-6 and TGF-β serve as effective, non-invasive biomarkers for early detection, monitoring and improved management of OPMDs.
Introduction: Functionalised carbon nanotubes (CNTs) are explored for their ability to enhance scaffold properties without compromising biocompatibility. This systematic review assesses studies on functionalised CNTs in periodontal tissue regeneration, synthesising evidence on their effectiveness in managing periodontitis and periimplantitis. Materials and Methods: Between March 2014 and April 2024, a comprehensive mixedmatch search was carried out using PubMed, PubMed Advanced, Scopus, The Cochrane Library (CDSR, CENTRAL and DARE) and Thomson Reuters Web of Science. The selected eight studies were assessed for quality using the risk of bias 2 (ROB2) tool. Results: From the 8 included studies, data regarding the subsequent parameters was taken out. Data extraction of included studieds was done along with risk of bias assessment. Conclusion: This study presents an overview of the use of functionalised and nonfunctionalised nanotubes as delivery routes for bioactive compounds and medications, as well as the functionalisation of these nanotubes to support periodontal regeneration.
Introduction:Loss of crestal bone is a common consequence in the post-extraction area, posing considerable hardships for dental professionals in making a decision regarding the best method for the extraction. The literature comparing flap versus flapless techniques often reports conflicting results, creating doubt. This research is important for defining and illustrating a successful ridge preservation technique. Materials and Methods:Twenty patients were included in this study and were divided into groups of flap and flapless. Group A (flap): Flap elevation, extraction of the tooth, debridement of the socket, graft/biological barrier placement and suturing. Group B (flapless) were performed in a similar manner by omitting the step of a loose flap elevation. We systemically prospectively documented the post-operative clinical and radiographic results. Results:The flapless method was significantly more effective for bone preservation than the conventional flap techniques. This was reflected in the mucosal height reductions, which were significantly less for the flapless approach, with less vertical bone loss being observed, thus showing its importance in preserving crestal bone height. Conclusions:Bone resorption occurred with both surgical modalities; however, the flapless approach had a consistent advantage with improved results. This suggests that there is some inevitable bone resorption, but that with the non-invasive technique, there was a significant reduction (P < 0.05) in the amount of bone resorption compared to its alternative.
Introduction: One of the foremost concerns that public health deals with is oral hygiene, especially in individuals with disability. People with disability are unable to rinse the mouth and follow the usual protocol for maintaining the oral hygiene due to manual dexterity. However, they require an alternative and feasible approach which facilitates compliance. Coconut oil pulling has proven to maintain the oral hygiene. The objective of the study was to investigate the efficacy of tooth brushing along with the application of coconut oil using foam swabs among the mentally challenged individuals. Materials and Method: 2 groups with 30 participants: The coconut oil swabbing group and the distilled water swabbing group. They were asked to perform swabbing with foam swabs with coconut oil and distilled water every day immediately after the conventional brushing. Plaque index and Streptococcus mutans count in plaque were recorded on day 0, 7, and 14. Intragroup and Intergroup results were analysed using the ANOVA test and unpaired t-test. Results: The overall plaque scores and the mean CFU of S. mutans showed highly significant decrease on 7th and 14th day in intervention group (P < 0.001) compared to the control group. Conclusions: Tooth brushing along with the application of coconut oil using foam swabs showed a highly significant reduction of plaque scores. Hence, it could be practical and sustainable alternative to coconut oil pulling in children having lack of manual dexterity with minimal use of resources.
Introduction: Augmentation of the alveolar ridge is one of the basic procedures in implant dentistry. It is essentially raising the ridge to accommodate dental implants. Ridge deficiency correction can be achieved using various methods, including guided bone regeneration (GBR), bone block grafting and synthetic/alloplastic grafting. This evaluates the effects of these procedures on the stability of implants, fit of prosthesis and volume of bone. Materials and Methods: A total of 100 individuals were enrolled in this prospective controlled study, and three augmentation techniques (GBR group, bone block group and synthetic graft group) were evaluated. Implant stability was evaluated by means of resonance frequency analysis, and bone volume and quality were radiographically assessed. Fit of the prosthesis was also assessed by clinical inspections and patients’ comments. One week, 1, 3 and 6 months after surgery, follow-ups were performed to monitor clinical and radiographic results. Results: The GBR group’s mean implant stability values surpassed all others. Moreover, they enjoyed the best-prosthesis fit, with 91% of participants indicating that the fit was ‘excellent.’ The GBR group also demonstrated significantly greater volumes and quality of bone, averaging 3.5 mm of bone height and 4.2 mm bone width gain. The bone block grafting and synthetic grafting groups demonstrated some moderate advancement in implant stability and bone volume, yet their outcomes were still below those of GBR. Conclusion: This study showed that GBR offers the highest benefit for alveolar ridge augmentation concerning implant stability, prosthesis adaptation and bone quality. The synthetic graft and bone block gave positive results.
Introduction: Evidence regarding the prognostic value of maternal Complete blood cell count (CBC) with foetal growth during pregnancy is lacking. Literature has shown that maternal hem constriction has been linked to pre-eclampsia. As well, preeclampsia, placental abruption and Intrauterine growth restriction (IUGR) share the same pathophysiology. This study wish investigate whether there is an association between maternal CBC indices and IUGR. A potential association may help physicians for early diagnosis and to establish a path for more rapid screening. Materials and Methods: The current case-control study was conducted on pregnant women admitted in the Baqiyatallah Hospital, Obstetrics ward from 2017 to 2022. The case group included pregnancies complicated with IUGR and the control group consisted of pregnant women with appropriate foetal growth. The two case and control groups were matched for variables such as patient age, gestational age, parity, miscarriage history and successful pregnancies. The specific biochemical variable of interest in this study was the complete blood count (CBC. diff) test. To determine the simultaneous effect of the investigated variables and the occurrence of IUGR, logistic regression was employed. Results: In this study, 90 cases (36.1%) and 146 (63.9%) controls were compared. There was not any significant difference between the two groups in terms of maternal age (P = 0.87), gestational age (P = 0.78), gravidity (P = 0.84), parity (P = 0.88), the number of previous miscarriages (P = 0.70) and live birth (P = 0.85). However, the mean counts of white blood cell WBC (P < 0.001), neutrophils (P < 0.001), lymphocytes (P = 0.038), haemoglobin (P = 0.047) and haematocrit (P = 0.037), and platelet counts (P = 0.002) were statistically higher in the case group. Logistic regression also showed WBC was correlated with IUGR occurrence (odds ratio: 1.306, confidence interval: 1.12–1.52, P = 0.001). Conclusion: In the third trimester of pregnancy, an increase of the leucocyte counts is associated with an increase in chance of having IUGR. Other variables from the complete blood test did not exhibit any significant associations in this regard.
