Six-year clinical performance of lithium disilicate glass-ceramic CAD-CAM versus metal-ceramic crowns

PURPOSE@#To assess the clinical performance of monolithic CAD-CAM lithium disilicate glass-ceramic (LDGC) crowns and metal-ceramic (MC) crowns provided by predoctoral students. This study also assessed the effects of patient and provider-related factors on their clinical performance as well as patient preference for these types of crowns. @*MATERIALS AND METHODS@#Twenty-five patients who received 50 crowns (25 LDGC CAD-CAM and 25 MC) provided by predoctoral students were retrospectively examined. LDGC CAD-CAM crowns were milled in-house using the CEREC Bluecam system and cemented with either RelyX Unicem or Calibra Esthetic resin cements. MC crowns were cemented with RelyX Unicem cement. Clinical assessment of the crowns and the supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Patients’ preference was recorded using a visual analog scale (VAS). The results were statistically analyzed using log-rank test, Pearson Chi-squared test and Kaplan-Meier survival analysis. @*RESULTS@#Twelve complications were observed in the MC crown group (9-esthetic, 2-technical and 1-biological). In comparison, 2 complications in the LDGC CAD-CAM crown group were observed (1-technical and 1-esthetic). The 6-year cumulative survival rates for MC crowns and LDGC CAD-CAM were 90.8% and 96%, respectively, whereas the success rates were 83.4% and 96%, respectively. Overall, patients preferred the esthetic outcomes of LDGC CAD-CAM crowns over MC crowns. @*CONCLUSION@#The high survival and success rates, low number of complications, and the high level of patients’ acceptance of monolithic LDGC CAD-CAM crowns lend them well as predictable and viable alternatives to the “gold standard” MC crowns.

Effect of benfotiamine on hepatic tissue levels of free calcium, copper, iron and zinc during CCI4-induced hepatotoxicity in rats

Toxic injury occurs in the liver more often than other organ, this can be attributed to the fact that virtually all ingested substances that are absorbed are first presented to the liver and that the liver is responsible for the metabolism and elimination of many substances. Carbon tetrachloride [CCI4] is very well known to cause hepatotoxicity that may be associated with impaired calcium and trace element homeostasis. This study was designed to evaluate the protective effect of benfotiamine against CCI4-induced disturbances in calcium, iron, copper and zinc homeostasis in liver tissue of rats. Liver tissue homogenate from normal controls, CCI4-treated and benfotiamine [70 mg/kg] pre-treated before induction of hepatic damage with CCI4 in rats were obtained, and processed for estimation of levels of free forms of calcium, iron, copper and zinc using atomic absorption spectrophotometry. Analysis of data revealed significant elevation in calcium, iron and copper levels in hepatic tissue due to exposure to CCI4 compared to controls, while zinc levels not significantly affected. Pretreatment with benfotiamine results in significant decrease in calcium, iron and copper levels compared to non-treated group, while zinc levels found to be significantly elevated. Benfotiamine has a protective effect against CCI4-induced hepatic tissue damage which may be, in part, attributed to restoration of calcium and other trace elements homeostasis

Plasma level of atrial natriuretic peptide during normal pregnancy and preeclampsia

To assess plasma a trial natriuretic peptide [ANP] level in pregnant and preeclamptic women, and to evaluate the role of this hormone in the defense mechanism against body fluids and electrolytes disorders encountered under such physiological and pathophysiological conditions. A case- series study. Al- Batool Teaching Hospital for Gynecology and Obstetrics, Mosul, during the period from December 2003 to September 2004. Twenty five women with normal pregnancy [group I] 25 pregnant women with preeclampsia [group II] and 25 healthy non pregnant women [control group] were included in this study. Plasma ANP, serum creatinine, urea, sodium and potassium were measured in all groups. Unpaired 't-test was used to examine the difference in the mean of the studied parameters between different groups. Pearson correlation was used to assess the relation between different parameters within each group. The mean of plasma ANP level was significantly higher in group [p<0.05] and group II [p<0.0001] than that in the control group. Furthermore, the plasma ANP level was significantly higher in group II [p<0.0001] than that in group I. The mean of serum creatinine and serum urea were significantly higher in group II than that in group I [p<0.005 and p<0.0001] and control group [p<0.0001 and p<0.0001]. The results of this study indicate that plasma ANP level significantly increases during pregnancy especially among those who develop preeclampsia. Since ANP plays an important role in the maintenance of body fluids and electrolytes homeostasis and blood pressure regulation, estimation of plasma ANP level may be of value in better understanding and management of pathophysiological conditions conditions that challenge the body homeostatic mechanisms during pregnancy

Atrial natriuretic peptide in chronic renal failure on maintenance hemodialysis: effect of heart failure

To examine the plasma level of a trial natruretic peptide [ANP] in patients with chronic renal failure [CRF] undergoing maintenance hemodialysis [HD] and to evaluate the effect of superimposed cardiac functional impairment on the plasma level of this hormone. A case-series study. A rtificial Kidney and Dialysis Unit of Ibn-Sena Teaching Hospital, Mosul; during the period from June 2003 to August 2004. Forty patients with CRF undergoing maintenance HD, were divided into 2 groups depending on presence or absence of heart failure. Group I, includes 20 patients with CRF who did not have heart failure and group II, includes 20 patients with CRF who had heart failure. The study also includes 20 healthy volunteers as a control group. Plasma ANP, serum creatinine, urea and body weights were measured in CRF patients before and after HD. The same parameters were also measured in the control group. The paired-t-test was used to examine the difference in the mean of the studied parameters in patients with CRF before and after HD. The Unpaired-t-test was used to assess the difference in the mean of the above-mentioned parameters between patients and control group. Pearson correlation coefficient was used to study the relation of the means of differences between pre and post dialysis values of the studied parameters within each patient group. The mean of plasma ANP level was significantly higher in group I [p<0.0001] and group II [p<0.0001] than that in the control group before and after HD. Furthermore, the plasma ANP in group II was significantly higher [p<0.0001] than that in group I. There was a significant decrease in the plasma ANP in group I [p<0.0001] and group II [p<0.0001] after HD. A significant positive correlation was found between the mean of decrease in plasma ANP level and body weight loss after HD in group I [r = 0.83, p<0.0001] and group II [r = 0.93, p<0.0001]. A similar positive correlation was found between the mean of decrease in plasma ANP and the mean of decrease in serum creatinine in group II [r = 0.95, p<0.0001], and between the mean of decrease in plasma ANP and the mean of decrease in serum concentration of urea in group 1 [r = 0.48, p<0.05]. Periodic measurement of plasma ANP level in patients with CRF may be of great value in evaluating the actual fluid status in patients having CRF and in determination of frequency and duration of dialysis sessions. It also may be of value in predicting cardiac dysfunction in patients with CRF

Surgical repair of urethral-cutaneous fistula in males

The results of surgical treatment of 18 cases of urethrocutaneous fistula in males were presented, 12 cases were secondary to hypospadias repair, 4 were associated with inflammatory strictures and 2 were complications of circumcision. The idea of de- epithelialized [pants over vest] was applied in four cases with coronal and subcoronal fistulae, while the transfer of a local peninsula shaped flap was done in 14 cases with fistulae on the shaft of the penis [scrotal or perineal]. The success rate was approximately 72%, it was significantly influenced by number of previously failed surgical procedures. The success rate was 50% in cases who underwent previous attempt at fistula closure, while it was 83.3% in cases who did not undergo previous fistula closure. To increase the chance of success, the repair should be delayed at least 4-6 months from the previous surgery, any distal obstruction must be corrected prior to fistula closure and healthy local skin is used for the creation of a local flap to cover the repaired urethral defect and to avoid any tension in the repair and overlapping of the suture lines

use of the lithoclast in the treatment of complex ureteral stones

Over a period of four years, stone fragmentation was attempted on 25 patients with complex stones located anywhere within the ureter using pneumatically-driven lithoclast. The overall success rate [defined as successful stone fragmentation and clearance] was encountered in 20 cases. Eighteen patients had successful fragmentation after one session, while two patients required a second session. Failure was recorded in five cases due to failed ureteroscopic access secondary to an associated distal ureteral stricture [two cases], inadvertent stone migration up to kidney [two cases] and unsuccessful fragmentation of a hard and large stone [one case]. Perioperative complications were minor and were treated conservatively. No major complications due to lithotripsy were recorded. The mean operative time was 65.3 minutes and the mean hospital stay was 2.2 days

Effects of oxytocin and dextrose 5% infusion during labor on neonatal serum sodium, glucose and bilirubin levels

Maternal serum sodium and glucose levels were measured in three groups of laboring women before and after labor. Cord serum samples were also analyzed for the same parameters as well as for bilirubin, and after 72 hours of labor, a neonatal serum sample was analyzed again for bilirubin. The study groups included cases who had full term vaginal delivery and who had no medical or obstetric complication The first group [group A] had neither fluid, nor oxytocin administration during labor. The second group [group B] received 5% glucose in water during labor. The third group [group C] received Oxytocin in 5% glucose infusion [1 unit in 100 ml]. All groups were comparable as regards maternal age, parity and gestational age. Newborns were comparable as regards birth weight and Apgar score, and weight of placenta. Maternal serum sodium [Na] and glucose did not show any significant correlation with cord serum values. Cord serum Na and glucose did not show significant correlation with the 72 hours neonatal serum bilirubin values. A significant increase in neonatal serum bilirubin was found in both groups B and C after 72 hours of birth. On the other hand, mean serum bilirubin [72 hours level] was higher in oxytocin group than in the control group and in the glucose only group. We concluded that the dose range used in this study [less than one litre - IV aqueous glucose solution given during labor] does not induce significant changes in either maternal or cord serum values of Na and glucose. Also oxytocin could be considered responsible of neonatal hyper bilirubinemia without inducing neonatal hyponatremia

Quantitative and qualitative estimation of tissue eggs burden in bilharzial patients clinicopathological correiation

Bilharziasis is the most common endemic disease in Egypt. Sequlae of pathological lesions and their severity vary considerably. This paper will show the correlation between the intensity, of infestation with the species of ova to the production of pathology. Tissue digestion technique was used to examine 64 biopsy specimens which included two from bilharzial contracted bladders, 16 from bilharzial bladder ulcers, seven cystectomy specimens from bilharzial patients with bladder cancer, and 22 from. bilharzial ureteric strictures. Of the remaining specimens, nine were from uncomplicated bilharzial bladders and eight from simple uncomplicated bilharzial ureters. The pathological lesions were found to be due to a mixed infestation [haemotobium and mansoni] in 63.5% of the cases of ureteric strictures, 68% of chronic bladder ulcers and 100% of bilharzial contracted bladders. The infestation was due to haemotobium only in 100% of simple Bilharzial bladder cases and in 87.5% of uncomplicated ureters. Accordingly, strains of schistosoma mansoni are more productive of tissue reaction and fibrosis, which can offer [an explanation for the varied clinical picture in different people. Management of urinary tract bilharziasis should cover both haemotobium and mansoni strains

Chromocystoscopic assisted trans-urethral resection of superficial bladder tumours

This study was done to evaluate the value of in vivo staining of malignant lesions of the bilharzial urinary bladder, using intravesical instillation of methylene blue, in optimizing the efficiency and completeness of transurethral resection of superficial tumors. Transurethral resection was performed in 30 bilharzial patients with superficial bladder tumors [Ta, T1]. Patients were divided into two groups. In the first group [16 patients], intravesical methylene blue instillation was done immediately before tumor resection and all stained areas were resected. In the second group [14 patients] transurethral resection was done without staining. An early second chromocystoscopy was done in both groups and areas that sustained the bluish discoloration were biopsied. Residual tumors were found in only 18.25% of the first group of patients, while residual tumor was detected in 35.7% of the second group of patients. Chromocystoscopic assisted transurethral resection of superficial bladder tumor proved to be superior to transurethral resection alone due to the reduced incidence of leaving malignant and premalignant lesions behind