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Aim: The aim of this study is to evaluate stress distribution on implants in ALL-ON-FOUR situation with varying distal implant angulations through finite element analysis (FEA). Materials and Methods: The study was conducted in the Department of Prosthodontics and crown & Bridge at Shree Bankey Bihari dental college and Research center. The FEA study was conducted at Anamac Design Private Limited Gurugram. A modeling software was used which is a solid modeling computer aided design (CAD) and computer aided engineering (CAE) computer program. Once a structure was numerically created and material properties was assigned which was analyzed for stress distributions during force application using finite element software. The stresses were expressed as compressive (which are negative) or tensile (which are positive). The global (x,y,z directional axes) combination of the absolute values squared of all stresses has evolved. Results: The statistical assessment was completed using statistical analysis software (SPSS). The highest overall deformation was observed in 450 group (0.1069) followed by 400 group (0.1067) and 300 group (0.1046). The highest overall stress was observed in 450 group (114.99) followed by 400 group (87.3624) and 300 group (81.7617). The highest Cortical Stress was observed in 30 degree group (78.79) followed by 400 group (72.17) and 450 group (70.98). The highest cancellous stress was observed in 300 group (4.56589) followed by 400 group (4.26808) and 450 group (4.10135). The highest posterior abutment stress was observed in 300 group (121.782) followed by 400 group (115.156) and 450 group (109.89). Conclusion: Within the limitations of the study it was concluded that in loading, the greatest stress values were found in the bone around the neck of the tilted implants. A significant increase in the stress was noticed when cantilever length was increased with implant angulations (30°, 40° and 45°). In oblique loading, maximum stress values on anterior abutment was observed in 300 model followed by 450 and less stress on 400 but in case of posterior abutment stress was more on 300 followed by 400 and less stress on 45o . [ABSTRACT FROM AUTHOR]

Objectives: Asthma affects about 15% of children while it is one of the commonest reason for admissions in pediatric emergencies and wards. We aimed this study to determine outcome of Salbutamol alone and salbutamol in combination with Ipratropium Bromide in acute asthma in children. Study Design: Randomized Controlled trial (RCT). Setting: Unit-II Department of Pediatric Medicine, Nishtar Medical College and Hospital, Multan. Period: 20th Nov 2017 to 30th June 2018. Material & Methods: The study consisted of 104 children, with 52 children each in Group ‘A’ and ‘B’ who were subjected to salbutamol alone and salbutamol in combination with Ipratropium bromide respectively. In both groups oxygen was administered via nasal prongs at a flow rate of 3L/minute. These children was monitored at 30 minutes interval for 2 hours (least value out of these 4 values was taken). Both groups were compared for outcome in terms of mean heart rate, respiratory rate, accessory muscle score, peak expiratory flow rate (PERF) percentage and SPO2. Results: Of these 104 study cases, 61 (58.7%) were boys while 43 (41.3%) were girls. Mean age of our study cases was noted to be 9.92 ± 3.01 years. Mild level of asthma severity was noted in 35 (33.7%) and moderate severity in 69 (66.3%). Mean heart rate in group A was noted to be 119.40 ± 12.22 and in group was 119.29 ± 8.51 beats per minute. (p=0.956). Mean respiratory rate in group A was 29.98 ± 4.00 while in group B was 27.88 ± 3.85 (p=0.000). Mean accessory muscle score in group A was 0.537 ± 0.336 while in group B was 0.130 ± 0.030 (p = 0.000). Mean PEFR percentage in group A was 68.69 ± 18.64 while in group B was 87.12 ± 17.10 (p = 0.000). Mean SPO2 in group A was 96.15 ± 1.05 while it was 95.94 ± 1.29 (p = 0.362). Conclusion: Our study results have shown that nebulization of salbutamol in combination with Ipratropium Bromide is more effective in the management of children with acute asthma. It was safe, effective and reliable as there was no adverse side effect noted in our study. We recommend the use of this combination nebulization therapy in children with acute asthma. [ABSTRACT FROM AUTHOR]