Large posterior defects located beneath the gingival tissues complicate the use of indirect bonded restorations. It probably invades the biological width, during rubber dam isolation, impression taking and adhesive procedures. This article proposes a literature review of a new minimally invasive technique known as cervical margin relocation which allows to relocate subgingival margin to supragingival level using an appropriate material. A literature search was conducted in the Medline/PubMed database following the main key words: “cervical margin relocation», «deep margin elevation”, “proximal box elevation”, “indirect restorations”, “adhesion”, “marginal adaptation”, “subgingival margin”. A total number of 44 articles were included.

Based on the reviewed literature, it can be concluded that cervical margin relocation technique emerged as an interesting alternative to surgical crown lengthening. However, further research, scientific evidence and randomized clinical trials with longer follow-up results are needed to clarify essentially the longevity of this technique and its compatibility with periodontal tissues.

Background: The main objective of the study was to access the nutritional status and dietary practice of elderly population living in community dwelling and old age home of Tanahun district, Nepal.

Methods: Community-based cross-sectional comparative study was conducted in Tanahun district. The Mini-Nutritional Assessment tool was used to investigate the nutritional status and dietary practices. It was identified by using weekly food consumption and 24 hours dietary recall questionnaires. Data were entered in Epi-Data (version 3.1) and analyzed by SPSS (version 20).

Result: Among 202 respondents (101 each from community dwellings and old age home), 44.5% were at risk of malnutrition, 5.9% were malnourished and 49.5% had normal nutrition status in community dwelling. Similarly, 55.4% were at risk of malnutrition, 17.8% were malnourished and 26.7% had normal nutrition status in old age home. In both settings, consumption of protein is low and consumption of vegetables is high. There was a significant association between socio-demographic variables such as living settings, age and education with nutritional status of elderly population. Age (AOR =0.0.186, p= 0.01) and education (AOR = 5.419, p= 0.006) shows significant association with nutritional status.

Conclusion: Overall half of them were at risk of malnutrition in both settings due to poor dietary practices, loss of appetite, weight loss, morbidity, neuropsychological problems among senior people. Cardinal focus should be given to improve the consumption of protein in dietary practices. Further longitudinal research studies should be conducted to determine factor associated with malnutrition to prevent malnutrition at regional and national level.

Background: Ventricular fibrillation is the principal cause of sudden cardiac death; in acute coronary syndrome (ACS) with elevated ST segment, its incidence and predictive factors, have been the subject of several international studies; however, its epidemiological data is lacking in Algeria.

Aims: The main objective of our study is the determination of the frequency of ventricular fibrillation in acute coronary syndrome with elevated ST segment, the secondary objective was the analysis of predictive factors of this arrhythmia, and related mortality.

Methods and materials:  In this prospective study, conducted in the cardiology department of Hussein Dey hospital (Algiers-Algeria), 467 patients with acute coronary syndrome with elevated ST segment (87 women and 380 men) were enrolled between 28 February 2014 and 16 July 2015. The average age is 60 ± 13 years; at admission, a Holter recorder was attached for continuous ECG monitoring during 48 hours

Kruskal’s ANNOVA or H tests were used for comparison of quantitative variables, χ2 test or Fisher’s exact test, were used for qualitative variables, all tests were performed with 1^st species risk of 5%.

Results:  The frequency of ventricular fibrillation is 5.8% (27 patients), CI 95%: [3.7%-7.9%], multivariate analysis identified the following independent predictors: low diastolic blood pressure: high ST segment elevation, large diastolic left and right ventricular diameters.

The risk of mortality expressed by Hazard Ration (HR) is 12.9 (CI 95%: [4.9-34], p < 0.001), the predictors of mortality are right ventricular failure and failure of thrombolysis.

Conclusion: Ventricular fibrillation is the principal cause of sudden cardiac death, during acute coronary syndrome with elevated ST segment, its predictive factors according to our study are: low diastolic blood pressure: high ST segment elevation, large diastolic left and right ventricular diameters, its occurrence increases the risk of hospital mortality, this high risk is partly explained by the therapeutic strategy.

Background: Tuberculous meningitis is a critical public health issue in underdeveloped nations due to its high morbidity and death. Tuberculous meningitis with non-specific symptoms of the central nervous system in children needs to be assessed with great vigilance as delay in diagnosis results in poor prognosis.

Case Report: We present a case of 20 months old female child with symptoms of sensory alteration, aberrant movements, and fever. Lumbar puncture findings indicated cell count of 1121/mm3, reduced glucose level, and elevated proteins. Ventriculomegaly with diffuse hypodenseimages in the frontal and paraventricular regions with areas of ischemia and hydrocephalus were evident in the MRI. Neuroinfection was indicated with images compatible with obstructive hydrocephalus of early evolution suggestive of tuberculous meningitis. The patient was started on 2HRZE/10 hr regimen. However, the patient was observed with significant neurological sequel and presented multiple comorbidities despite supportive measures.

Conclusion : Children are more susceptible to tuberculous meningitis than adults and result in death and disability, if not diagnosed early. Hence, the physicians must always be on the alert for tuberculous meningitis, especially in the areas where tuberculosis is endemic

The onset and progression of diabetic nephropathy represent a significant issue in diabetic management as it is the primary microvascular consequence of both type 1 and type 2 diabetes mellitus and a significant contributor to end stage renal disease-related mortality. Major risk factors for nephropathy in children and adolescents include hyperglycemia, HbA1c, diabetes duration, gender, blood pressure, dyslipidemia, uric acid, family history and genetic factors, smoking, puberty, and obesity. Metabolism and hemodynamic variables interact on a complex basis during disease development. A series of intricate molecular events take place in response to hyperglycemia, which disturbs the body's metabolic environment and causes glomerular enlargement, tubular inflammation, mesangial expansion, oxidative stress, and renal fibrosis. Fortunately, the main approaches for preventing the beginning and reducing the progression of diabetic kidney damage are rigorous glucose control and antihypertensive medications. As children and adolescents with T1D are at risk for developing early diabetic nephropathy, patients with T1D must have the best metabolic control, an early diagnosis, and timely treatment of dyslipidemia and hypertension. Prospects for better diabetic nephropathy outcomes are improving as novel approaches are developed. Novel biomarkers are increasingly proven to be more reliable instruments than the traditional microalbuminuria, which can forecast the development of disease. In addition to glomerular and tubular indicators, inflammation and oxidative stress markers have proven to be reliable diagnostic aids. In order to emphasize the methods being employed lately to enhance therapeutic approaches in diabetic nephropathy, certain emerging critical biomarkers are illustrated in this review.

Synovial Osteochondromatosis is not  rare  in joint pathology.An orthopaedic surgeon may have around 30 cases in life career. The inner surface of synovium is presumably affected by inflammatory process and forms the osteochondral body. By the time this osteochondral formation detaches from synovium and becomes loose body in the joint. Synovial Osteochondromatosis is a pathological status in which there are multiple loose bodies inside the joint. Synovial Osteochondromatosis is presumably a benign disorder, but whose common complication is blockade of joint when loose body incacerated between cartilages of joint causing acute pain and joint cannot move.In medical terminology there is Osteochondromatosis who is a different pathology, a kind of benign bone tumors, not the title of this article. Multiple loose bodies can be detected by Feeling- the- Rice- Bag Sign. Place the hand over the involved joint, we can feel the loose bodies as if we feel the rice grain in the bag. More loose bodies exist, easier we feel. More superficial the joint and/or loose bodies are , easier feeling is recognized.Feeling -the -Rice- Bag  Sign is pathognomonic manifestation for the Synovial Osteochondromatosis.

Background: Medical errors are considered as a major threat to patient safety. The objective of our study was to describe essential steps in drug circuitry from prescription to administration at the University Hospital Center of Point-G.

Methods: We conducted a prospective cross-sectional study design at the University hospital center of Point G from January 30, 2021 to June 30, 2021. We collected data using a Case Report Form (CRF) and reviewed medication order sheets, medication administration records, and patient charts. To identify the independent predictors of medication errors, we analyzed the collected data using Stata version 12.

Results: The study included 41 patients with 96 prescriptions with 35 medication errors. The highest error rate was detected in prescription step (15.6%) followed by administration drug step (12.5%) and drug dispensation step (8.3%). The most frequent type of errors  was the prescription of wrong drug combination (65.85%) followed by wrong indication (36.58%), wrong treatment duration (12.2%), wrong medication dispensing (15.5%), drug erroneously omitted during dispensation (4.4%), wrong drug delivery during dispensation (64%), wrong route for drug administration (20%) and wrong frequency of administration (12%). These errors did not compromise the health of the patients.

Conclusion: Medication errors were common at the University Hospital of Point G involving mainly errors in drug prescription, administration and dispensation.

In this review we have collected information about errors that occur in gynecological and obstetric cases. Mistakes are an integral part of every sector, but our task should be to recognize and report mistakes. This will prevent problems that may appear later. Organizations promote health professionals in announcing their mistake to the person’s family but also to the person herself. Various error cases are described demonstrating the variety of errors that exist. In this way, health professionals and other people, possibly future patients, should understand that error is part of everyday life. Finally, health tips are suggested.

It is widely accepted that the field of obstetrics and gynecology is one of the most challenging specialties, due to the high expectations regarding patients' safety, irregular working hours and great sense of responsibility surrounding it. Medical errors among obstetricians, midwives and nurses consist a significant problem which arises in this field. Numerous factors have been shown to affect the occurrence of obstetric errors. Not only is raising awareness of the potential causes of high importance, but it can also contribute to the reduction of adverse events and unfortunate patient outcomes.

Anesthesiologists are particularly familiar with neurophysiology: anesthetic pharmaceutical agents have the Central Nervous System (CNS) as their primary - if not exclusive - site of action.Cerebral circulation, its management, and its changes during anesthesia concern the anesthesiologist every day, not only when dealing with neurosurgical cases but very often in every surgical patient: history of stroke, transient ischemic attack (tIA), or presence of extracranial carotid stenosis in patients who will undergo an unrelated operation belong to the daily anesthetic practice.

The other, non-organic (for now) or better, non-macroscopic side of the brain is less known to the anesthesiologist. It is a fact that psychiatric disorders occur less frequently than organic lesions of the CNS in surgical patients. In conjunction with that, no particular anesthetic technique is required, and the perioperative degradation of or ignoring these diseases is common practice. Nevertheless, the anesthetist must have basic knowledge of psychiatric diseases, the therapeutic techniques where it is called upon to contribute, and, above all, the pharmaceuticals administered to psychiatric patients. Their potential drug interactions with anesthetics and other perioperative drugs may result in increased perioperative morbidity and mortality.

TLS (tumor lysis syndrome) is a serious consequence of haematologic malignancies and their treatment. The condition is defined by laboratory abnormalities alone (laboratory TLS) or in conjunction with clinical consequences such as renal failure, seizures, and arrhythmias (clinical TLS). Clinical TLS is a risk factor for increased morbidity and death in cancer patients, although it may be avoided. As a result, accurate prediction is crucial to the effective management of patients at risk for TLS, and it takes into account both disease characteristics (tumor kind and load) and patient factors (baseline renal insufficiency or hyperuricaemia). In low- and intermediate-risk individuals, water and allopurinol are used to prevent TLS, whereas rasburicase is used in high-risk patients.

Background: The transmission of SARS-CoV-2 from mother to fetus and the development of protective antibodies in newborns are critical aspects of maternal and neonatal care during the COVID-19 pandemic. Understanding the association between umbilical cord IgG COVID-19 antibody levels and maternal factors, including gestational age of acquiring infection, COVID-19 clinical category, and immunization status, can provide insights into neonatal immunity and guide strategies for optimizing maternal and neonatal care.

Methods: This study aimed to investigate the association between umbilical cord IgG COVID-19 antibody levels and maternal factors in a cohort of pregnant women with confirmed SARS-CoV-2 infection. Maternal data, including gestational age of acquiring infection, COVID-19 clinical category, and immunization status, were collected. Umbilical cord blood samples were obtained at delivery, and IgG COVID-19 antibody levels were measured using standardized assays. Statistical analyses were performed to assess the associations between maternal factors and neonatal antibody levels.

Results: Preliminary results showed that gestational age of acquiring infection was positively associated with umbilical cord IgG COVID-19 antibody levels (p<0.001). Neonates born to mothers infected in the third trimester had significantly higher antibody levels compared to those infected in the first or second trimesters. Additionally, there was a significant positive correlation between COVID-19 clinical category and umbilical cord IgG antibody levels, with more severe maternal illness associated with higher neonatal antibody levels. Maternal immunization status also demonstrated a positive association with umbilical cord IgG COVID-19 antibody levels, indicating that vaccinated mothers had higher levels of antibodies transferred to their infants.

Conclusion: This study highlights the association between umbilical cord IgG COVID-19 antibody levels and maternal factors, including gestational age of acquiring infection, COVID-19 clinical category, and immunization status. The findings suggest that infection in the third trimester, more severe maternal illness, and maternal immunization are associated with higher levels of neonatal antibodies. These results have important implications for understanding neonatal immunity and guiding maternal and neonatal care during the COVID-19 pandemic. Further research with larger cohorts is warranted to validate these findings and inform evidence-based strategies for optimizing maternal and neonatal outcomes.

Mastitis in lactating cows lead to a decrease in the overall cow production; make milk unfit for human and calf consumption; deteriorate milk quality. However, data are not updated on the influence of mastitis on the physicochemical and microbiological quality of milk. Therefore, the present review was made to highlight the current state of knowledge on prior research on the impact of mastitis on milk quality, and to identify the shortcomings of these studies. Two themes were addressed to achieve this. We started by reviewing the prevalence, aetiology and factors associated with the occurrence of mastitis in the African continent. Then, we compared the variation of chemical components of mastitis milk in several studies. Our analysis shows that subclinical mastitis is predominant in Africa, with most prevalence higher than 50%. The majority of authors (83.33%) claimed that Staphylococci are the main cause of mastitis. The breed (83.33%) and lactation stage (66.66%) were the two most cited factors contributing to the occurrence of mastitis. Data collected on the chemical components of mastitis milk came mostly from studies prior to the year 2000. Several contrary opinions (increase/decrease/no variation) were stated by authors on the variation of chemical components of mastitic milk, specifically on fat, lactose and crude protein contents. Overall, it is challenging, if not impossible, to draw a definitive conclusion about the influence of mastitis on the chemical composition of milk for most chemical parameters, because the data examined in relation to the chemical components of milk with mastitis seem rather inconsistent.

Warts are one of the common dermatological disorders caused by human papilloma viruses encountered in our day to day life. These are cutaneous or mucosal infection needs proper care and treatment to prevent its transmission and complete healing. Although mostly warts are dealt with the therapeutic approach, i.e. on the basis of its peculiar type and location but it can even be successfully treated by constitutional approach. This article is regarding a case of warts treated successfully with Rhus Tox followed by Ferrum Met selected as the simillimum and proved its effectiveness in a short period of time.