Association of dietary pattern and childhood obesity with cardiovascular disease in patients from Tangail city, Bangladesh

@#Introduction: Obesity in childhood is a major cause for developing cardiovascular diseases (CVD) at adulthood. The present study was a cross-sectional research aimed to examine the relationship between childhood obesity and dietary pattern with CVD in patients (n=100) from Tangail City, Bangladesh. Methods: Dietary patterns, laboratory tests, demographic, and anthropometric interrelated data were measured in patients with stroke and heart attack from five hospitals. The research also used 24-hour recall method and a food frequency questionnaire for assessing daily energy and macronutrient intakes. Results: Weight (p=0.004), body mass index (BMI) (p=0.001), mid-upper arm circumference (MUAC) (p=0.009), and waist circumference (WC) (p=0.030) was significantly different between males and females whereas lipid profile was not significantly different between genders. There were no significant associations between intakes of red meat, salt, fast food, fish, egg, nuts and seeds with heart attack and stroke. On the contrary, there were significant associations between fried food intake with heart attack and stroke (p=0.080 and p=0.020). The results indicated that there was a significant relationship between carbohydrate (p=0.001), protein (p=0.001), and fat (p=0.001) intakes with the total energy intake of respondents. The findings also showed that there was a significant relationship between carbohydrate (p=0.003), protein (p=0.001), and fat (p=0.001) intakes with body mass index of the respondents. Conclusion: CVD diagnosis in adult patients was found to be associated with fried food intake but not with childhood obesity.

Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

ABSTRACT Objective: To describe oral healthcare services administered during the lockdown in the Eastern Mediterranean region and to investigate the role of socio-professional characteristics of dental practitioners or their self-reported COVID-19 infection. Material and Methods: A questionnaire was distributed to dental practitioners in all healthcare sectors in Jordan, Egypt, and Saudi Arabia. Results: There was a total of 335 participants, with the majority being females (N=225, 67.2%) and general practitioners (N=202, 60.3%). Cellulitis was the most common emergency encountered (N=108). The most common urgent procedures were for pulpitis, abscesses, and pericoronitis (N=191, 130, and 95, respectively). Country-specific significant associations were pulpitis in Egypt and Jordan, broken symptomatic teeth in Jordan, and biopsy in Egypt (p<0.05). The Ministry of Health was significantly associated with the management of dental infections, avulsion, and orthodontic emergencies, while university hospitals were significantly associated with advanced restorative procedures (p<0.05). Male practitioners performed significantly more procedures, particularly surgical emergencies (p<0.05). Conclusion: Dental infections were the most common complaints among dental patients during lockdown. Countryand sector-specific dental procedures are detected. Male gender seems to play a determinant role in performing a higher number of procedures, particularly for surgical emergencies (AU).

Evaluation of descriptive performances of platelet indices, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio in aortic dissections

SUMMARY OBJECTIVE: Mechanical damage resulting from aortic dissection creates a thrombus in the false lumen, in which platelets are involved. Platelet index is useful for the function and activation of platelets. The aim of this study was to show the clinical relevance of the platelet index of aortic dissection. METHODS: A total of 88 patients diagnosed with aortic dissection were included in this retrospective study. Demographic data and hemogram and biochemistry results of the patients were determined. Patients were divided into two groups: deceased and surviving patients. The data obtained were compared with 30-day mortality. The primary outcome was the relationship of platelet index with mortality. RESULTS: A total of 88 patients, 22 of whom were female (25.0%), diagnosed with aortic dissection, were included in the study. It was determined that 27 (30.7%) of the patients were mortal. The mean age of the entire patient group was 58±13 years. According to the DeBakey classification of aortic dissection of the patients, the percentages of the 1-2-3 type were determined as 61.4, 8.0, and 30.7%, respectively. Platelet index was not found to be directly related to mortality. Increase in age, decrease in bicarbonate value, and presence of diabetes mellitus were associated with mortality. CONCLUSION: Although there were no significant changes in platelet index in aortic dissection, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were found to be high in line with the literature. In particular, the presence of advanced age diabetes mellitus and decrease in bicarbonate are associated with mortality.

Early Mortality Predictors in İnfective Endocarditis Patients: A Single-Center Surgical Experience

ABSTRACT Introduction: Infective endocarditis is a disease that progresses with morbidity and mortality, afecting 3-10 out of 100,000 people per year. We conducted this study to review the early outcomes of surgical treatment of infective endocarditis. Methods: In this retrospective study, 122 patients who underwent cardiac surgery for infective endocarditis in our clinic between November 2009 and December 2020 were evaluated. Patients were divided into two groups according to in-hospital mortality. Demographic, echocardiographic, laboratory, operative, and postoperative data of the groups were compared. Results: Between November 3, 2009, and December 7, 2020, 122 patients were operated for infective endocarditis in our hospital. Emergency surgery was performed in nine (7.3%) patients. In-hospital mortality occurred in 23 (18.9%) patients, and 99 (81.1%) patients were discharged. In-hospital mortality was related with older age, presence of periannular abscess, New York Heart Association class 3 or 4 symptoms, low albumin level, high alanine aminotransferase level, and longer cross-clamping time (P<0.05 for all). Conclusion: The presence of paravalvular abscess was the most important prognostic factor in patients operated for infective endocarditis.

Primary myxofibrosarcoma of the male breast: A case report

Myxofibrosarcoma is an unusual type of malignant fibrous histiocytoma that arises in subcutaneous tissue in the limbs of elderly patients and uncommonly involves the breast.We report a rare case of myxofibrosarcoma that occurred in a male breast. A 57-year-old man was referred to our department for a right breast mass. Physical examination revealed an irregular lump without skin involvement. Ultrasonography and mammography showed an oval and hypoechoic opacity with increased internal vascularity. The patient had a core needle biopsy that showed a sarcoma of the breast. The patient underwent a simple mastectomy. The pathology report confirmed the diagnosis of high-grade myxofibrosarcoma of the breast and the patient had local radiotherapy. After a follow-up of 18 months, the patient has no evidence of local recurrence or distant metastases. Myxofibrosrcoma of the breast is extremely rare but should be diagnosed as soon as possible because of the rapid growth of the tumor and the better prognosis in the early stages.

Coevality of Secondary Syphilis with Condyloma Acuminata in a HIV reactive MSM: Rare Triple Sexually Transmitted Infections

Summary@#Secondary syphilis is a rare infectious sexually transmitted disease caused by Treponema pallidum in present era. It affects skin as well as other organs of the body. We hereby present a case of an adult male who presented with a one-month history of multiple brownish red maculopapular lesions all over the skin of the body involving the palms, soles, oral cavity and genitalia. His serology was positive for HIV, VDRL and TPHA with a low CD4 count. The patient was treated with three weekly doses of parenteral Benzathine penicillin G, antiretroviral therapy and podophyllin for condyloma acuminata to which he responded well.

Somatotype characteristics of patients with non-dialysis chronic kidney disease and its relationships with physical activity and depression / Características del somatotipo de pacientes con enfermedad renal crónica sin diálisis y su relación con la actividad física y la depresión

SUMMARY: Somatotype characters have been defined for many diseases. However, there is insufficient information on the somatotype characters of chronic kidney patients. The first aim of our study was to define the specific somatotype in patients diagnosed with CKD. The second aim was to investigate the relationship between somatotype characters and physical activity and depression in CKD patients. A total of 88 (52.7 %) patients diagnosed with CKD between January and December 2021 at the Department of Nephrology, Inonu University Hospital (Malatya, Turkey) and 79 (47.3 %) healthy volunteers were included in the study. Somatotype analysis was performed using the Heath-Carter method. Physical activity was assessed with the International Physical Activity Questionnaire (IPAQ) and depressive symptoms with the Beck Depression Inventory (BDI). Analysis revealed that patients had greater medial calf girth (p = 0.036), higher triceps (p = 0.007) and suprailiac (p = 0.042) skinfold thicknesses and higher body mass index (p = 0.007) compared to controls. Patients also had significantly higher endomorphy (patients: 6.57±1.35 vs. controls: 6.04±1.3; effect size (ES): 0.40, p=0.010) and significantly higher mesomorphy (patients: 7.44±2 vs. controls: 6.85±2.3; ES: 0.27, p=0.039) as well as significantly lower ectomorphy (patients: 0.71±0.69 vs. controls: 1.10±0.93; ES: 0.47, p=0.006). Significant positive correlations were also observed between mesomorphy and IPAQ (rho = 0.219, p = 0.04), endomorphy and BDI (rho = 0.423, p 0.001). Significant negative correlations were observed between ectomorph and BDI (rho = -0.325, p = 0.002). We observed that the dominant somatotype was endomorphic mesomorph in patients with CKD. In addition, the fact that CKD patients with ectomorphic body structure have lower depressive symptoms could have an impact on their well-being.

RESUMEN: Se han definido caracteres de somatotipo para muchas enfermedades. Sin embargo, no hay suficiente información sobre los caracteres somatotípicos de los pacientes renales crónicos. El primer objetivo de nuestro estudio fue definir el somatotipo específico en pacientes diagnosticados de ERC. El segundo objetivo fue investigar la relación entre los caracteres del somatotipo y la actividad física y la depresión en pacientes con ERC. Se incluyeron en el estudio un total de 88 (52,7 %) pacientes diagnosticados con ERC entre enero y diciembre de 2021 en el Departamento de Nefrología del Hospital Universitario de Inonu (Malatya, Turquía) y 79 (47,3 %) voluntarios sanos. El análisis del somatotipo se realizó mediante el método de Heath-Carter. La actividad física se evaluó con el Cuestionario Internacional de Actividad Física (IPAQ) y los síntomas depresivos con el Inventario de Depresión de Beck (BDI). El análisis reveló que los pacientes tenían una mayor circunferencia media de la pierna (pantorrilla) (p = 0,036), tríceps (p = 0,007) y pliegues cutáneos suprailíacos (p = 0,042) más altos y un IMC más alto (p = 0,007) en comparación con los controles. Los pacientes también tenían una endomorfia significativamente mayor (pacientes: 6,57±1,35 frente a controles: 6,04±1,3; tamaño del efecto (ES): 0,40, p=0,010) y una mesomorfia significativamente mayor (pacientes: 7,44±2 frente a controles: 6,85±2,3; ES: 0,27, p=0,039) así como una ectomorfia significativamente menor (pacientes: 0,71±0,69 vs. controles: 1,10±0,93; ES: 0,47, p=0,006). También se observaron correlaciones positivas significativas entre mesomorfia e IPAQ (rho = 0,219, p = 0,04), endomorfia y BDI (rho = 0,423, p 0,001). Se observaron correlaciones negativas significativas entre ectomorfo y BDI (rho = -0,325, p = 0,002). Observamos que el somatotipo dominante fue el mesomorfo endomórfico en pacientes con ERC. Además, el hecho de que los pacientes con ERC con estructura corporal ectomórfica tengan menos síntomas depresivos podría tener un impacto en su bienestar.

Evaluation of fracture strength and total void amount in composite restorations on endodontically treated teeth / Resistencia a la fractura y la cantidad total de burbujas en resinas compuestas de dientes tratados endodónticamente

ABSTRACT: The aim of the study was to investigate the fracture strength of different composite resins and the quantity of voids in conventional posterior composite, high- flow flowable composite, bulk-fill flowable composite, and fiber-reinforced composite. Forty-four caries-free, freshly extracted mandibular premolars were used for this study. Teeth were prepared for cavity and root canal treatment. Subsequently, root canal treatment was applied to the teeth and cavities in order to prepare them for restorations. The specimens were then divided into four groups: group-1: Estelite Posterior; group-2: Estelite Flow Quick High Flow; group-3: Estelite Bulk-fill Flow; group-4: everX Posterior. One specimen from each experimental group was examined using micro-CT to perform measurement of voids. The fracture strength values of high-flow flowable, bulk-fill flowable, fiber-reinforced, and conventional micro- hybrid composites were found to be similar (p=0.497). EverX Posterior showed the highest fracture strength values (841.1±149.4 N), followed by Estelite Bulk-fill Flow (822.8±170.8 N). Volume of voids (%) obtained from Micro-CT analysis revealed that restorations with high-flow liner or bulk-fill flowable exhibited more voids. The fiber-reinforced composite showed the lowest percentage volume of incorporating voids and the highest fracture strength results.

RESUMEN: El objetivo del estudio fue investigar la resistencia a la fractura de diferentes resinas compuestas y la cantidad de burbujas en resinas posteriores convencionales, resinas fluidas de alto flujo, resinas fluidas tipo bulk-fill y resinas reforzados con fibras. Cuarenta y cuatro premolares mandibulares libres de caries, recién extraídos, fueron usados para este estudio. Los dientes se prepararon para el tratamiento de conductos radiculares y las cavidades para prepararlos para las restauraciones. Los especímenes se dividieron en cuatro grupos: Grupo-1: Estelite Posterior; Grupo-2: Estelite Flow Quick High Flow; Grupo-3: Estelite Bulk-fill Flow; Grupo-4: everX Posterior. Un espécimen de cada grupo experimental fue examinado usando micro-CT para realizar la medición de las burbujas. Los valores de resistencia a la fractura de los compuestos de alto flujo, flujo de relleno, reforzados con fibra y microhíbridos convencionales fueron similares (p=0,497). EverX Posterior mostró los valores más altos de resistencia a la fractura (841,1±149,4 N), seguido de Estelite Bulk-fill Flow (822,8±170,8 N). El volumen de las burbujas (%) obtenido del análisis de Micro-TC reveló que las restauraciones con revestimiento de alto flujo o con flujo de relleno a granel presentaban más huecos. El compuesto reforzado con fibra mostró el menor porcentaje de volumen de incorporación de vacíos y los resultados más altos de resistencia a la fractura.

Parental Attitudes towards Children with Intellectual Disability in Special Schools of South India.

Background: Parental attitude is one of the key prognostic factors in psychosocial development of a child. In this cross-sectional study conducted in the special schools among parents, we explored the dimensions of parental attitudes towards children with intellectual disability and the factors that influence these attitudes. Methodology: Data was collected using Rangaswamy Parental Attitude Scale. This scale consists of 40 items spread equally into 8 domains (over protection, acceptance, rejection, permissiveness, communication, attitudes towards education, home management and hostility). Results: The study revealed that parents have an overall positive attitude towards their children with intellectual disability. However, mean score of the subscale domains indicates parental negative attitudes which is highest on over protection and lowest on rejection. Conclusions: Further studies in this regard are needed across multiple centres to validate the findings of the above study.

Microtensile Bond Strength Between Self-Adhesive Resin Cements and Resin Based Ceramic CAD/CAM Block / Resistencia adhesiva microtensil entre cementos de resina autoadhesivos y bloques de cerámica CAD/CAM a base de resina

Abstract: Purpose: The objective of this study is to evaluate and compare the microtensile bond strength (μTBS) of four different self-adhesive resin cements to a resin-based ceramic CAD/CAM block, at the baseline, and after subjecting them to 5,000 thermo-cycles.Materials and Methods: Four self-adhesive dual-cured resin cements; G-CEM LinkAce (GC EUROPE, Leuven, Belgium), RelyX U200 (3M ESPE, Seefeld, Germany), Maxcem Elite (Kerr, CA, USA), TheraCem (Bisco, Schaumburg, USA) were applied to Cerasmart CAD/CAM blocks (GC EUROPE, Leuven, Belgium). CAD/CAM blocks were sectioned into sticks and subjected to µTBS tests at 24 hours, and the other half were subjected to tests after 5000 thermo-cycles. The data were tested by one-way variance analysis (p<0.05). Results: The highest bond strength values were observed in TheraCem, followed by G-CEM LinkAce and RelyX U200, respectively (p<0.05). At the baseline, G-CEM LinkAce, RelyX U200, and Maxcem Elite showed statistically similar results. After 5,000 thermal-cycles, a significant decrease was observed in the bond strength values of G-CEM LinkAce (p<0.05). Conclusion: Between the adhesive cements used in the study, TheraCem showed the highest micro-tensile bond strength values both in the baseline (24h) results, and after the 5,000 thermal- cycle aging procedures.

Resumen: Propósito: Evaluar y comparar la resistencia adhesiva microtensil (μTBS) de cuatro cementos de resina autoadhesivos diferentes con un bloque CAD/CAM de cerámica a base de resina, antes y después de 5.000 ciclos de termociclado. Materiales y métodos: cuatro cementos de resina de doble curado autoadhesivos; G-CEM LinkAce (GC EUROPE, Lovaina, Bélgica), RelyX U200 (3M ESPE, Seefeld, Alemania), Maxcem Elite (Kerr, CA, EE. UU.), TheraCem (Bisco, Schaumburg, EE. UU.) fueron aplicados a bloques Cerasmart CAD/CAM (GC EUROPE, Lovaina, Bélgica). Los bloques CAD/CAM se seccionaron en barras y se sometieron a pruebas µTBS a las 24 horas, y la otra mitad se sometió a pruebas después de 5000 ciclos térmicos. Los datos fueron probados por análisis de varianza unidireccional (p<0.05). Resultados: Los valores más altos de fuerza de unión se observaron en TheraCem, seguido de G-CEM LinkAce y RelyX U200, respectivamente (p<0.05). En la línea de base, G-CEM LinkAce, RelyX U200, Maxcem Elite mostró resultados estadísticamente similares. Después de 5.000 procesos de ciclo térmico, se observó una disminución significativa en los valores de resistencia de la unión de G-CEM LinkAce (p<0.05). Conclusión: entre los cementos adhesivos utilizados en el estudio, TheraCem mostró los valores más altos de resistencia de la unión micro-extensible tanto en la línea de base (24 h) como después de 5,000 procedimientos de envejecimiento térmico.

Knowledge and Practice of Hearing Screening and Hearing Loss Management among Ear, Nose, and Throat Physicians in Jordan

Abstract Introduction One of the main factors that affect the early diagnosis and intervention of hearing loss is inadequate knowledge by the health care workers. Ear, nose, and throat (ENT) specialists are the main source of information about hearing loss and its management in most developing countries, such as Jordan. Objective The purpose of the present study is to explore the level of knowledge and the practice of hearing screening and hearing loss management for children among ENT physicians in Jordan as an example of health care providers in developing countries of the Middle East. Methods This was a cross-sectional study, adapting a questionnaire of knowledge and the practice of hearing screening and hearing loss management for children. The questionnaire consisted of 2 sections with 20 questions. A total of 40 ENT physicians completed the questionnaire. Results The majority of the respondents acknowledged the importance of hearing screening for children; however, there was limited knowledge regarding hearing loss management and testing. Only 10 of the ENT physicians believed that a referral to an audiologist is warranted, and the majority of the respondents were not aware that a child with a confirmed permanent hearing loss should be referred to a speech pathologist or to a rehabilitation center. Managing unilateral and mild sensorineural hearing loss (SNHL) was another area about which ENT physicians have limited knowledge. Conclusion There is a strong need for professional intervention programs, providing the latest updates and standardizations in the field of audiology and pediatric rehabilitation for ENT physicians.

Genetic and clinical characteristics of pediatric patients with familial hemophagocytic lymphohistiocytosis

Background@#Our study was designed to investigate the frequencies and distributions of familial hemophagocytic lymphohistiocytosis (FHL) associated genes in Saudi patients. @*Methods@#FHL associated gene screening was performed on 87 Saudi patients who were diagnosed with hemophagocytic lymphohistiocytosis (HLH) between 1995 and 2014. The clinical and biochemical profiles were also retrospectively captured and analyzed. @*Results@#Homozygous mutations and mono-allelic variants were identified in 66 (75.9%) and 3 (3.5%) of the study participants, respectively. STXBP2 was the most frequently mutated gene (36% of patients) and mutations in STXBP2 and STX11 accounted for 58% of all FHL cases and demonstrated a specific geographical pattern. Patients in the FHL group presented at a significantly younger age than those belonging to the unknown-genetics group (median, 3.9 vs. 9.4 mo; P =0.005). The presenting clinical features were similar among the various genetic groups and the 5-year overall survival (OS) was 55.4% with a 5.6 year median follow-up. Patients with PRF1 mutations had a significantly poorer 5-year OS (21.4%, P =0.008) and patients undergoing hematopoietic stem cell transplant (72.4%) had a significantly better 5-year OS (66.5% vs. 0%, P =0.001). @*Conclusion@#Our study revealed the predominance of the STXBP2 mutations in Saudi patients with FHL. A genetic diagnosis was possible in 80% of the cohort and our data showed improved survival in FHL patients who underwent hematopoietic stem cell transplant.

Genetic and clinical characteristics of pediatric patients with familial hemophagocytic lymphohistiocytosis

Background@#Our study was designed to investigate the frequencies and distributions of familial hemophagocytic lymphohistiocytosis (FHL) associated genes in Saudi patients. @*Methods@#FHL associated gene screening was performed on 87 Saudi patients who were diagnosed with hemophagocytic lymphohistiocytosis (HLH) between 1995 and 2014. The clinical and biochemical profiles were also retrospectively captured and analyzed. @*Results@#Homozygous mutations and mono-allelic variants were identified in 66 (75.9%) and 3 (3.5%) of the study participants, respectively. STXBP2 was the most frequently mutated gene (36% of patients) and mutations in STXBP2 and STX11 accounted for 58% of all FHL cases and demonstrated a specific geographical pattern. Patients in the FHL group presented at a significantly younger age than those belonging to the unknown-genetics group (median, 3.9 vs. 9.4 mo; P =0.005). The presenting clinical features were similar among the various genetic groups and the 5-year overall survival (OS) was 55.4% with a 5.6 year median follow-up. Patients with PRF1 mutations had a significantly poorer 5-year OS (21.4%, P =0.008) and patients undergoing hematopoietic stem cell transplant (72.4%) had a significantly better 5-year OS (66.5% vs. 0%, P =0.001). @*Conclusion@#Our study revealed the predominance of the STXBP2 mutations in Saudi patients with FHL. A genetic diagnosis was possible in 80% of the cohort and our data showed improved survival in FHL patients who underwent hematopoietic stem cell transplant.

Awareness and Knowledge of Breast Cancer Screening Methods among Women in Al-Qunfudah, Saudi Arabia

Objectives: Breast cancer is the most common malignancy affecting women in Saudi Arabia. Screening helps in early detection and prompt treatment of breast cancer, leading to a better prognosis. Lack of knowledge and awareness of its screening methods can lead to bad outcomes. So far, little is known of women’s knowledge of breast cancer screening. This study was conducted to assess the knowledge, attitudes, and practice of breast cancer screening among Saudi women in Al-Qunfudah.Methods: This is a cross-sectional study including 203 adult Saudi women aged 18 years and above. Data were collected through a self-administered questionnaire from Saudi women in Al-Qunfudah, Saudi Arabia in 2019. The data were entered and statistically analyzed using SPSS software.Results: Findings revealed that all the participants in this study heard of breast cancer, and their awareness of breast self-examination was high (93.6%). Awareness levels were lower concerning clinical breast examination (63.1%) and mammography (65.5%). However, only 43.3% correctly practiced breast self-examination, and 5.9% had ever heard of a mammogram. Knowledge of breast cancer screening with mammography screening was significantly related to participant age (P=0.04), marital status (P=0.008), and occupation (P=0.04). Furthermore, the relation between participants who underwent mammography and age was significant (P=0.001).Conclusion: Our data indicate that the knowledge, awareness, and practices were insufficient, and educational interventions are required inAl-Qunfudahto encourage young women to practice screening for early detection

The relation between active smoking and colposcopical and cytological findings in the cervix uteri

Background: All types of smoking have been associated with cervical neoplasia, and the long-term of use tobacco products and intensity of smoking could influence cervical carcinogenesis. The aim of this study is to identify the association between smoking and the presence of colposcopical and cytological abnormalities in cervix uteri.Methods: An observational case-control study was applied on 100 patients to investigate this relationship. The patients were divided into two groups, smokers’ group (70) cases and nonsmokers’ group (30) cases. All of the patients have been submitted to colposcopy and Papanicolaou smear. Comparison of colposcopic and cellular findings between both groups was done.Results: Authors found that there was a significance difference in the rate of abnormal colposcopical findings between two groups. This rate in smokers’ sample was 45.7% and in the second was 26.7% with p-value=0.04. Additionally, there was no significance difference in the rate of abnormal cytological findings. This rate in smokers’ group was 32.9% whereas in the second was 23.4% with p-value=0.6.Conclusions: This study data suggests that smoking increases abnormalities in papanicolaou smear and colposcopy.

Quackery and Superstitions: The Skin Doctor’s Bane

@#Camphor, a waxy white sublimable chemical, widely used worldwide by various communities for many religious purposes. Here we report a clinical image of self-inflicted injury from burning camphor on the palm resulting in burns. It also highlights the sociocultural pattern of this injury and need of psychopathic and therapeutic help of the patients.

Alleviating Diagnostic Dilemma of Maduramycosis: A Case Series

@#Maduramycosis1 is chronic infection of cutaneous and subcutaneous tissue caused by bacteria and fungi. It involves skin, subcutaneous tissue and bones.2 Here we report a case series of 14 patients of mycetoma describing their epidemio-clinical features and laboratory investigations. The most common clinical presentation in the patients were infiltrated subcutaneous swelling with multiple discharging sinus tracts (fistulas). Lesions were located on the foot in all the cases.

Cytotoxic effects of different self-adhesive resin cements: Cell viability and induction of apoptosis

PURPOSE@#. The effects of four different self-adhesive resin cement materials on cell viability and apoptosis after direct and indirect exposure were evaluated using different cell culture techniques. @*MATERIALS AND METHODS@#. Self-adhesive cements were applied to NIH/3T3 mouse fibroblasts by the extract test method, cell culture inserts, and dentin barrier test method. After exposure periods of 24 h and 72 h, the cytotoxicity of these self-adhesive materials was evaluated using the MTT assay (viability) and the Annexin-V-FITC/PI staining (apoptosis). @*RESULTS@#.The lowest cell viability was found in cells exposed to BeautiCem SA for 24 h in the extract test method. Cell viability was reduced to 70.6% compared to negative controls. After the 72 h exposure period, viability rate of cell cultures exposed to BeautiCem SA decreased more than 2- fold (29.5%) while cells exposed to RelyX U200 showed the highest viability rate of 71.4%. In the dentin barrier test method, BeautiCem SA induced the highest number of cells in apoptosis after a 24 h exposure (4.1%). Panavia SA Cement Plus was the material that caused the lowest number of cells in apoptosis (1.5%). @*CONCLUSION@#. The used self-adhesive cements have showed different cytotoxic effects based on the evaluation method. As exposure time increased, the materials showed more cytotoxic and apoptotic effects. BeautiCem SA caused significantly more severe cytotoxic and apoptotic effects than other cements tested. Moreover, cements other than BeautiCem SA have caused necrotic cell death rather than apoptotic cell death.

Effects of Non-invasive Neurostimulation on Autism Spectrum Disorder: A Systematic Review

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by major impairments in social communication, stereotyped and ritualistic behaviors and deficits in sensory reactivity. Recently, noninvasive brain stimulation (NIBS) methods, namely transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), have been examined as possible new therapeutic options for modifying the pathological neuroplasticity involved in neuropsychiatric disorders including ASD. Therefore, we conducted a systematic review on the therapeutic uses of tDCS and repetitive TMS (rTMS) in ASD patients. A systematic search was performed on Scopus, Web of Science, PubMed, Cochrane and Embase. Original articles reporting the use of tDCS or rTMS to treat ASD were screened and studied by two researchers independently based on PRISMA guidelines. We found 32 eligible studies including 8 tDCS reports, 23 rTMS reports and one report with both tDCS and rTMS. These studies comprised 6 case-reports, 9 non-controlled trials and 17 controlled trials which assessed NIBS effects on the three cognitive, behavioral and biological dimensions in ASD. Existing evidence demonstrates that NIBS methods could be helpful for treating some dimensions of ASD such as repetitive behavior, sociability or some aspects of executive and cognitive functions. However, such evidence should be regarded with care because of the quality of original researches and serious publication bias as well as the heterogeneity of data. Further randomized, double-blind, sham-controlled trials with appropriate follow-up periods should be designed to assess the efficacy of NIBS methods for ASD treatment.

Apical extrusion of bacteria following the use of reciprocating single-file and rotary multi-file instrumentation systems in oval root canals / Extrusão apical de bactérias após o uso de sistemas alternativos de instrumentação de arquivo único e rotativo de arquivo múltiplo em canais radiculares ovais

Objective: All instrumentation techniques and instruments are associated with apical extrusion during chemomechanical preparation, and this causes postoperative pain and flare-up. However, it is controversial whether reciprocal systems or rotary systems cause more apical extrusion. The objective of this in vitro study was to determine the differences in the amounts of apically extruded bacteria (AEB) associated with nickel-titanium rotary and reciprocating systems when used in oval-shaped root canals. Material and Methods: Seventy human mandibular premolar teeth with oval-shaped canals were randomly assigned to four experimental groups (15 teeth in each group) and one control group (10 teeth). The root canals were contaminated with Enterococcus faecalis and instrumented using two full-sequence rotary instruments (ProTaper Universal [PTU] and ProTaper Next [PTN]) and two reciprocating single-file instruments (Reciproc [R] and WaveOne [WO]). A 0.9% NaCl solution was used as an irrigant, and the bacterial extrusion was quantified as the number of colony-forming units for each sample. The results were statistically analyzed using the Kruskal-Wallis one-way analysis of variance and the Mann-Whitney U test, and the statistical significance level was set at p < 0.05. Results: The R system was associated with the highest amount of bacterial extrusion (p < 0.05). The PTU system caused more bacterial extrusion than the PTN and WO systems (p < 0.05). There was no significant difference between the PTN and WO systems (p > 0.05). Conclusions: All instrumentation techniques caused apical bacterial extrusion. The instrument design and preparation techniques affect the number of extruded bacteria (AU)

Objetivo: Todas as técnicas e instrumentos de instrumentação estão associados à extrusão apical durante o preparo quimomecânico, o que causa dor e surto no pós-operatório. No entanto, é controverso se sistemas recíprocos ou rotativos causam extrusão mais apical. O objetivo deste estudo in vitro foi determinar as diferenças na quantidade de bactérias apicalmente extrudadas (AEB) associadas aos sistemas rotativo e alternativo de níquel-titânio quando usadas em canais radiculares em forma oval. Material e Métodos: Setenta dentes pré-molares inferiores humanos com canais em forma oval foram divididos aleatoriamente em quatro grupos experimentais (15 dentes em cada grupo) e um grupo controle (10 dentes). Os canais radiculares foram contaminados com Enterococcus faecalise instrumentados usando dois instrumentos rotativos de seqüência completa (ProTaper Universal [PTU] e ProTaper Next [PTN]) e dois instrumentos alternativos de arquivo único (Reciproc [R] e WaveOne [WO]). Uma solução de NaCl a 0,9% foi usada como irrigante e a extrusão bacteriana foi quantificada como o número de unidades formadoras de colônias para cada amostra. Os resultados foram analisados estatisticamente usando a análise de variância unidirecional de Kruskal-Wallis e o teste U de Mann-Whitney, e o nível de significância estatística foi estabelecido em p < 0,05. Resultados: O sistema R foi associado à maior quantidade de extrusão bacteriana (p < 0,05). O sistema PTU causou mais extrusão bacteriana que os sistemas PTN e WO (p < 0,05). Não houve diferença significativa entre os sistemas PTN e WO (p > 0,05). Conclusões: Todas as técnicas de instrumentação causaram extrusão bacteriana apical. O desenho do instrumento e as técnica (AU)