abnormal placental implantation and abnormal trophoblast invasion rather than decidual deficiency only.
  Breech presentation is associated with increased rates of maternal and perinatal morbidity regardless of mode of delivery.  https://www.selleckchem.com/products/ulonivirine.html  After the results of Term Breech Trial, most of the countries adopted the protocol of cesarean section for term breech delivery because of which breech vaginal delivery is becoming rare. The aim of this study is to evaluate short-term maternal and perinatal outcomes of breech vaginal delivery at a tertiary care hospital in Nepal.
 
  A retrospective review of case records of all women who had vaginal breech delivery from April 13, 2016, to April 12, 2018, was conducted, over a period of two years. Available demographic variables, obstetric characteristics, details of labor, postpartum complications, and perinatal complications were recorded and analyzed.
 
  Out of 21,768 cases of deliveries during the study period, the incidence of term breech deliveries was 528 (2.4%) among which the mode of only 84 (17.8%) deliveries was vaginal. Most of the deliveries were unplanned and were conducted because emergency cesarean section could not be performed. Three (3.6%) women had postpartum hemorrhage, and four (4.8%) had entrapment of aftercoming head, two of them requiring Dührssen incisions. Adverse perinatal outcomes were seen in 23.8% of such deliveries with <7 APGAR score at 5 minutes in 20.2%, neonatal admission in 17.7%, and perinatal mortality in 8.3%. The perinatal mortality was significantly associated with birthweight less than 2500 grams as compared to birthweight ≥2500 grams (21.1% versus 4.6%; 
  =0.043).
 
  The perinatal outcomes for vaginal breech delivery are grave with our existing health facilities, especially when the deliveries are not well planned.
 The perinatal outcomes for vaginal breech delivery are grave with our existing health facilities, especially when the deliveries are not well planned.Sickle Cell Anaemia (SCA) is associated with a hypercoagulable state resulting in a predisposition to venous thromboembolism. With improvements in the quality of care, more patients with SCA survive into adulthood with an associated increase in the frequency of end-organ damage and chronic complications such as chronic leg ulcers (CLUs). These ulcers rarely occur in the first decade of life and are recurrent, painful, and slow-to-heal. This study tested the hypothesis that coagulation is enhanced in SCA patients with CLU. 145 participants (50 SCA with CLU, 50 SCA without CLU, and 45 with haemoglobin AA) were assessed to determine their coagulation profile using selected tests of coagulation. The SCA with the CLU group had the lowest mean haemoglobin (Hb) concentration. SCA patients with and without CLUs had elevated mean platelet counts, shorter mean aPTT, and marginally prolonged mean PT  compared to HbAA patients. SCA with CLUs patients had a significantly shortened aPTT than those without CLUs (p = 0.035) and HbAA (p = 0.009). There were significant differences in the mean PT between SCA with CLUs patients and HbAA (p = 0.017); SCA without CLU and HbAA (p = 0.014). SCA with and without CLUs patients had higher mean D-dimer levels compared to HbAA. There was a negative correlation between Hb concentration and duration of CLU (r = -0.331, p = 0.021). In conclusion, our study demonstrates a heightened hypercoagulability in SCA patients with CLUs. We did not test for platelet activation, and it is not clear what role, if any, the enhanced hypercoagulability plays in the pathogenesis of CLUs in SCA. It will be useful to ascertain if antiplatelet agents or/and anticoagulants quicken the healing of CLUs in SCA patients.
  To assess the awareness, knowledge, and treatment decisions by dentists in Jordan regarding tooth wear.
 
  A questionnaire was disseminated to a random sample of 200 general dentists and 100 prosthodontists working in the Ministry of Health, academia, private practices, and military services. Chi square and independent 
  -tests were performed for statistical analysis.
 
  Hundred and seventy-nine dentists and prosthodontists responded (59.7% response rate), of which 71.5% was females. 83.8% of the dentists reported they see patients with tooth wear. 61.5% registered wear lesions in the patient file, and 68.2% reported they find a probable cause of tooth wear. 87.2% of the dentists reported that bruxism is the most common cause in Jordan. 63.3% dentists treated their patients. 46.4% reported they "always" record a dietary history. 77.7% did not think that tooth wear is linked to caries. Low confidence levels were demonstrated among general practitioners in diagnosing and treating tooth wear. Regarding treatmententists and prosthodontists on applying the minimally invasive approach. Clinical Significance. It is challenging for dentists to make the best treatment decision for tooth wear especially as no standard treatment is available. Therefore, this study investigated the awareness and treatment decisions of a sample of dentists and prosthodontists in Jordan.The bone of yellowfin tuna (Thunnus albacares) contains high calcium and phosphor and can be synthesized into hydroxyapatite (HA). Due to its mineral content and similarity in chemical composition with human hard tissue, HA may have potency as a pulp capping material. The aim of this in vitro study was to evaluate the viability and alkaline phosphatase (ALP) activity of dental pulp cells after exposure to HA synthesized from yellowfin tuna bone (THA). Pulp cells were isolated from human-impacted third molar. To evaluate the viability of the pulp cells, the cells were cultured and exposed to various concentrations (6.25 to 200 μg/ml) of THA for 24, 48, and 72 hours. For ALP activity assay, pulp cells were cultured with odontoblastic differentiation media and exposed to THA for 7, 11, and 15 days. ALP activity was then determined using an ALP colorimetric assay kit. Results showed that the viability of the cells was more than 91% after exposure to various concentrations of THA and the cells demonstrated normal cell morphology in all observation periods.