Effect of implant diameter and cantilever length on the marginal bone height changes and stability of implants supporting screw retained prostheses: A randomized double blinded control trial

PURPOSE@#. This randomized controlled trial aimed to evaluate the effect of implants’ two different diameters and cantilever lengths on the marginal bone loss and stability of mplants supporting maxillary prostheses. @*MATERIALS AND METHODS@#. Ninety-six implants were placed in sixteen completely edentulous maxillary ridges. Patients were randomly divided into two groups: Group A, implants were placed with a cantilever to anterior-posterior AP spread length (CL:AP) at a ratio of 1:3; Group B, implants were placed with a CL:AP at a ratio of 1:2. Patients were further divided into four sub-groups: Groups A1, A2, B1, and B2. Groups A1 and B1 received small diameter implants while Groups A2 and B2 received standard diameter implants. Bone height and stability measurements around each implant were performed at 0, 4, 8 and 24 months after definitive prostheses delivery. @*RESULTS@#. Statistical analysis of the mean implant stability and height values revealed an insignificant difference between Group A1 and Group A2 at all the different time intervals while significantly higher values in Group B1 in comparison with Group B2. Results also showed significantly higher values in Group A1 in comparison with Group B1 and an insignificant difference between Group A2 and Group B2 at all the different time intervals. @*CONCLUSION@#. It can be concluded that the use of small diameter implants placed with a CL:AP at a ratio of 1:3 provided predictable results and that the 1:2 CL:AP significantly induced more critical bone loss in the small diameter implants group, which can significantly reduce long term success and survival of implants [J Adv Prosthodont 2023;15:101-13]

Plasma Levels of Connective Tissue Growth Factor in Children with Congestive Heart Failure

Objectives: Assessment ofplasma level of connective tissue growth factor in congestive heart failure children,assessment of its diagnostic and prognostic role and correlate its level with clinical and echocardiographic assessment of congestive heart failure.Methods: Connective tissue growth factorlevel in the plasma was measured in 40 children; 20 of them have congestive heart failure, and 20 are healthy then,correlated with clinical parameters. Results: The diagnostic and prognostic value of itwas evaluated. Wecompareditslevels in both patientsand healthy children. We found that connective tissue growth factor level was significantly increased in diseased children. Fractional shortening and ejection fraction correlated negatively with the plasma levelof connective tissue growth factor. Heart rate, respiratory rate and calibrated integrated backscatter correlated positively with connective tissue growth factor. Connective tissue growth factorwas significantly correlated with the class of heart failure according to Ross classification.Conclusions: Plasma connective tissue growth factor has a promising diagnostic and prognostic value as a biomarker for congestive heart failure in children with high sensitivity and specificity.

Group B Streptococcus Colonization, Antibiotic Susceptibility, and Serotype Distribution among Saudi Pregnant Women / 감염과화학요법

Background@#Group B Streptococcus (GBS) comprises the normal flora of the female urogenital tract and can be transferred to neonates during delivery, causing invasive diseases.This study was performed to investigate the colonization rate, antibiotic susceptibility, and serotype of GBS among Saudi pregnant women. @*Materials and Methods@#In this cross-sectional study, vagino-rectal swabs from 400 pregnant women were collected over a period of one year. Identification of GBS isolates and determination of their antibiotic susceptibility were performed using the Microscan Walk Away system. The isolates were then typed using both latex agglutination and capsular genebased multiplex polymerase chain reaction assays. @*Results@#Sixty (15.0%) subjects were colonized by GBS, with serotype Ia as the dominant type (30.0%) followed by serotype III and V (25.0%, each). Only 43 (71.7%) isolates were typed by latex agglutination, whereas the remaining isolates were not typable or were non-specifically typed as compared to the genotyping assay, which revealed the specific type of each GBS isolate. The highest resistance rates were observed for erythromycin and clindamycin (16.7%, each), which were mainly restricted to the prevalent serotypes. @*Conclusion@#This study is the first to report the distribution of GBS serotypes based on molecular genotyping in Saudi Arabia. GBS colonization was evident among pregnant women, and resistance to erythromycin and clindamycin was predominant among serotypes Ia, III, and V. Molecular genotyping using capsular gene-based multiplex PCR provided reliable typing of the investigated GBS isolates in terms of sensitivity and specificity as compared to conventional serotyping using latex agglutination.

Ultrasonographic enthesis evaluation in patients with recurrent acute anterior uveitis with and without spondyloarthropathy

Background: spondyloarthritis (SpA) is a group of chronic diseases recognized by arthritis and extraarticular lesions e.g. uveitis, enthesitis, dermatological affection. About 35% of SpA patients may present with recurrent attacks of acute anterior uveitis (AAU). Purpose: it was to detect whether patients with idiopathic recurrent AAU who were positive or negative for Human Leukocyte Antigen B27 (HLA­B27) had a frequency of enthesis lesions compared to that seen in patients with SpA. Patients and Methods: a prospective study of enthesis evident on musculoskeletal ultrasound examination was done on sixty patients and twenty controls, the eighty were categorized into 4 groups; group 1 included 20 patients with known SpA group 2 included 20 with recurrent AAU HLA­B27 positive and didn't have SpA aspects group 3 included 20 with recurrent AAU HLA­B27 negative and didn't have SpA and group 4 included 20 healthy controls. Using Madrid Sonography Enthesitis Index (MASEI) twelve enthesis locations were assessed in each participant. Results: a total of 960 entheses sites were examined by ultrasonography in all 80 participants. The MASEI cut-off limit of ≥18 points was 75%, 60%, 45%, and 10% of the participants in the 4 groups; respectively. The MASEI score was significantly higher in groups 1&2 than in groups 3&4. The differences between the two groups were statistically significant. Conclusion: a high percent of HLA­B27 positive patients with idiopathic recurrent AAU without characteristics of SpA have enthesis lesions with about percent to those seen in patients with known SpA

Prospective study of intraoperative intrauterine contraceptive device application during cesarean section

Background: intrauterine contraceptive device [IUCD] is the most widely used method of reversible fertility regulation in the world. Over 100 million women worldwide use it for contraception. Many cultures have addressed the need for successful fertility regulation by embracing and expanding IUCD. IUCD is one of the most popular methods of contraception in Europe and Latin America, ranging from 10% to 30% of women contraception. In Cuba, Egypt, and North Korea, IUCD use accounts for more than 50% of contraceptive use. In China, 83% of married women used contraception and 36% of these women used IUCDs

Patients and methods: this prospective study was conducted at Al-Galaa Maternity Teaching Hospital, dated from 20/7/2016 to 20/1/2017, where 100 pregnant women attending the antenatal clinic were included according to special criteria

Results: according to our results, the PPIUCD was demonstrably safe, having no reported incidence of perforation, pregnancy with low rates of expulsion, pain abdomen, pelvic infection and lost strings. Continuation rate in intra-cesarean insertion was higher compared to vaginal insertion

Conclusion: routinely offering insertion of IUC at the time of elective cesarean section was popular among women. In addition, this study confirmed the low complication rate associated with insertion of IUCD at this time and an expulsion rate in keeping with that of insertion of IUC in women who are not postpartum

Role of magnetic resonance spectroscopy in grading of primary brain tumors

To assess the usefulness of MR spectroscopy [MRS] in grading of primary brain tumors. MRS was performed in a 22 patients with primary brain tumors. Metabolite ratios of Choline [Cho] / N-acetyle Laspartate [NAA]. Cho/ Creatine [Cr], Cho+Cr/NAA as well as lipids and lactate [LL]/Cr were calculated at short and intermediate echo time [TE]. Additionally, myoinositol [ml]/Cr was calculated at short TE. Tumors were subdivided into low grades and high grade on the basis of histopathology Receiver operating characteristic analysis of metabolite ratios was performed to find the cut off values between high and low grade tumors. The resulting sensitivity, specificity and accuracy were calculated. At intermediate TE, Cho/NAA, Cho+Cr/NAA and Cho/Cr were significantly higher in high grade tumors than in low grade ones. At short TE, Cho/Cr and LL/Cr ratios were significantly higher in high grade tumors than in low grade ones. The diagnostic accuracy of metabolite ratios at intermediate TE was 86% whereas at short TE, the diagnostic accuracy was 75%. Combination of both TEs revealed a diagnostic accuracy of 88%. Cho/NAA, Cho+Cr/Cr/NAA and Cho/Cr are reliable in determining the tumor grade. LL/Cr is highly related to high grade tumors. Combination of both short and intermediate TEs provides better accuracy, in grading of brain neoplasm, compared to that when using each TE separately

Effect of electrical muscle stimulation on prevention of ICU acquired muscle weakness and facilitating weaning from mechanical ventilation

ICU acquired muscle weakness [ICUAMW] is an acquired neuromuscular disorder associated with increased duration of mechanical ventilation and weaning suggesting a possible relation between the limb and respiratory neuromuscular involvement. There is no preventive tool and no specific treatment has been proposed for ICU acquired muscle weakness. Aim of this study was to assess the effect of electrical muscle stimulation on prevention of ICUAMW and in facilitating the weaning from mechanical ventilation in critically ill patients. A prospective, randomized, placebo-controlled trial. Critical care department, main Alexandria university hospital. 80 Critically ill patients on mechanical ventilation for more than 24 h. They were randomly categorized into two groups: 40 patients received conventional lines of treatment only [control group] and 40 patients received in addition one daily session of Electrical Muscle Stimulation [EMS] [EMS group]. Assessment of occurrence of ICUAMW was done through the MEDICAL RESEARCH COUNCIL SCALE [MRCS] which is a method for clinical assessment of muscle strength. MRCS did not show any significant difference between the two groups in the first 3 days post mechanical ventilation while on day 4, MRCS mean value was 46.86 +/- 10.88 in the EMS group versus 43.70 +/- 9.32 in the control group [p= 0.041]. On day 21, MRCS mean value was 29.67 +/- 8.87 in the EMS group versus 19.60 +/- 4.34 in the control group [p=0.037]. Significant difference was also noted in the duration of mechanical ventilation as the mean value in the EMS group was 9.01 +/- 8.01 days versus 11.97 +/- 8.07 in the control group [p= 0.048]. Although the EMS could not prevent the occurrence of ICUAMW in critically ill mechanically ventilated patients it still has a role in minimizing the degree of muscular weakness and could be helpful in facilitating weaning from mechanical ventilation

Crypto-Giardia antigen rapid test versus conventional modified Ziehl-Neelsen acid fast staining method for diagnosis of cryptosporidiosis

OBJECTIVE@#To evaluate the validity of Crypto-Giardia antigen rapid test (CA-RT) in comparison with the conventional modified Ziehl-Neelsen acid fast (MZN-AF) staining method for the diagnosis of cryptosporidiosis.@*METHODS@#Fifteen preserved stool samples from previously confirmed infections were used as positive controls and 40 stool samples from healthy people were used as negative control. A total of 85 stool samples were collected from suspected patients with cryptosporidiosis over 6 months during the period from January till June, 2011. The study was conducted in the department of parasitology, central laboratory, Alnoor Specialist Hospital, Makkah, Saudi Arabia. All samples were subjected to CA-RT and conventional MZN-AF staining method. Validation parameters including sensitivity (SN), specificity (SP), accuracy index (AI), positive predictive value (PPV), and negative predictive value (NPV) were evaluated for both tests.@*RESULTS@#Out of 15 positive controls, CA-RT detected 13 (86.7%) while MZN-AF detected 11(73.3%) positive cases. However, CA-RT detected no positive case in 40 normal controls but MZN-AF detected 2(5%) as positive cases. Based on the results, the SN, SP, AI, PPV and NPV were high in CA-RT than MZN-AF staining method, ie., 86.7%vs. 73.3%, 100%vs. 95%, 96.4%vs. 89.1%, 100%vs. 84.6% and 95.2%vs. 90.5%, respectively. Out of a total of 85 suspected specimens, CA-RT detected 7(8.2%) but MZN-AF detected 6(7.1%) cases as positive.@*CONCLUSIONS@#CA-RT immunoassay is more valid and reliable than MZN-AF staining method.

Assessment of quality of life among children with atopic dermatitis

Patients with skin diseases experience a wide range of symptoms, which affect their lives, ranging from trivial problems to major handicaps. Sometimes, these symptoms are caused by objective changes that impair daily life directly and measurably, while at other times the impairment is subtle and occurs mainly on psychological level. The aim of this work is to study the impact of atopic dermatitis on the quality of life [QOL] among affected children. The aim of this work is to study the impact of atopic dermatitis [AD] on the quality of life [QOL] among affected children. One hundred child aged 7-13 years were the cases of the study. They were selected from the patients attending the dermatology outpatient clinic at El-Hussin University Hospital. Also, one hundred child were selected as a control with age and sex matching. Quality of life was assessed for patients and controls through a specific questionnaire. The QOL was good among 24% of cases in comparison to 88% of controls. It was observed that 91.3% with severe AD had poor QOL, while, 37.5% with mild severity had good QOL with statistical significance difference. The QOL of patients with atopic dermatitis is clearly impaired with comparison to control group. QOL showed strong negative effect with increase the severity of the disease

Correlation of interleukin-6 in vaginal secretions with neonatal infection, histologic chorioamnionitis, and umbilical cord pH in patients with premature prelabor rupture of membranes

The objective of this study was to evaluate the diagnostic value of interleukin-6 bedside test in vaginal secretions for neonatal infections, histologic chorioamnionitis and neonatal acidemia in pregnant ladies with prelabor premature rupture of membranes above 34 weeks. The study was a prospective clinical study performed on 50 patients with prelabor premature rupture of membranes above 34 weeks. Interleukin-6 in vaginal secretions was determined in less than 20 minutes by and immunochromatographic bedside test. A positive strong correlation was present between vaginal interleukin-6 and each of the three parameters [p=0.000]: histologic chorioamnionitits [r=0.561], early onset neonatal infection [r=0.836], and umbilical pH [r=0.723]. The test showed sensitivity [87.5%, 72.7%, 95%], specificity [88.4%, 84.6%, 80%], positive predictive value [87.5%, 80%, 90.4%] and negative predictive value [88.4%, 78.5%, 96.4%] respectively. Vaginal interleukin-6 represents an effective bedside test for the screening and prediction of early on set neonatal infection, histologic chorioamnionitis and neonatal acidemia in premature prelabor rupture of membranes

Radiographic absorptimetry of trabecular bone pattern: a forensic marker for identification

Forensic pathologists and anthropologists use radiographic comparison for identification purpose for its uniqueness and stability overtime. The reliability of identification process is increased with the increasing number of methods used, so the need for methological variation is a must. The aim of the present study was to verify the reliability of trabecular bone pattern as a marker for identification and to investigate the influence of degenerative bone changes [osteoporosis] on trabecular archietecture overtime period. The sample studied in this research entailed forty-eight post menopausal wonen, Dual energy X-ray absorptiometry [DEXA] and Plan X-ray to wrist, lumber spine femoral regions were done at the beginning of research and after one year. Bone mineral density [BMD], Z score, T score and degree of osteoporosis were determined, twicely. The uniqueness and stability of trabecular pattern over one year period was examined using densitographs of wrist region [radius]. A computerized technique [contour program] was used to compare densitographs of same individuals [one year apart] and of different individuals, correlation coefficients were calculated for all possible combinations of pairs of densitographs. The results showed that the degree of osteoporosis was increased with age. A significant relation between the degree of osteoporosis and T score as well as Z score was encountered in our sample. A cut-off level r= 0.70 [of correlation coefficients] was estimated for positive identification of trabecular pattern densitographs of the same individual. In conclusion; densitographs of trabecular bone can be used as a quantifiable method for identification of humans in all age groups. Also, it is not influenced by bone degenerative diseases

Radiographic absorptiometry of trabecular bone pattern: a forensic marker for identification

Forensic pathologists and anthropologists use radiographic comparison for identification purpose for its uniqueness and stability overtime. The reliability of identification process is increased with the increasing number of methods used, so the need for methodological variation is a must. The aim of the present study was to verify the reliability of trabecular bone pattern as a marker for identification and to investigate the influence of degenerative bone changes [osteoporosis] on trabecular architecture overtime period. The sample studied in this research entailed forty-eight post menopausal women, Dual energy X-ray absorptiometry [DEXA] and Plain X-ray to wrist, lumber spine and femoral regions were done at the beginning of research and after one year. Bone mineral density [BMD], Z score, T score and degree of osteoporosis were determined, twicely. The uniqueness and stability of trabecular pattern over one year period was examined using densitographs of wrist region [radius]. A computerized technique [contour program] was used to compare densitographs of same individuals [one year apart] and of different individuals, correlation coefficients were calculated for all possible combinations of pairs of densitographs. The results sowed that the degree of osteoporosis was increased with age. A significant relation between the degree of osteoporosis and T score as well as Z score was encountered in our sample. A cut-off level r=0.70 [of correlation coefficients] was estimated for positive identification of trabecular pattern densitographs of the same individual. In conclusion; densitographs of trabecular bone can be used as a quantifiable method for identification of humans in all age groups. Also, it is not influenced by bone degenerative diseases