Is there an effective way to control pain perception after free gingival graft removal? A systematic review and meta-analysis

Abstract The literature describes multiple ways to stimulate wound healing to reduce the patient's perception of pain. This systematic review aimed to evaluate if methods that enhance wound healing can reduce the patient's perception of pain after free gingival graft removal from the palate region compared to natural healing. A systematic review protocol was written following the PRISMA checklist. Electronic searches of five databases were performed to identify randomized clinical trials (RCTs) that assessed the patient's perception of pain after the removal of a free gingival graft from the palate. The primary outcome was the visual analog scale (VAS) score assessing the patient's perception of pain 7 days after the free gingival graft removal from the palate region. Of the 1,622 potentially relevant articles retrieved from the electronic databases, 16 RCTs were selected for qualitative analysis, and of these, 6 RCTs were included in the meta-analysis. RCTs showed a significant VAS reduction associated with the use of methods to enhance wound healing. The pooled estimates revealed a significant overall VAS reduction of 2.20 (95% CI 2.32, 2.07) 7 days after surgery. The methods that presented the greatest reduction in the perception of pain were platelet-rich fibrin, hyaluronic acid, and autologous fibrin glue. Methods that enhance wound healing, including platelet-rich fibrin, hyaluronic acid, and autologous fibrin glue, can reduce pain perception after free gingival graft removal in the palate region. However, only 1 RCT investigated each approach, which hinders the conclusion regarding the best procedure to reduce the perception of pain.

Resumo A literatura descreve diferentes formas de estimular a cicatrização para reduzir a percepção de dor do paciente. Esta revisão sistemática teve como objetivo avaliar se métodos que melhoram o reparo de feridas podem reduzir a percepção de dor do paciente após a remoção de enxerto gengival livre da região do palato quando comparado a cicatrização natural. Um protocolo de revisão sistemática foi escrito seguindo a lista de verificação PRISMA. Pesquisas eletrônicas em cinco bancos de dados foram realizadas para identificar ensaios clínicos aleatorizados (ECA) que avaliaram a percepção de dor do paciente após a remoção do enxerto gengival livre do palato. O desfecho primário foi o escore da escala visual analógica (VAS) avaliando a percepção de dor do paciente 7 dias após a remoção do enxerto gengival livre da região do palato. Dos 1.622 artigos potencialmente relevantes recuperados das bases de dados eletrônicas, 16 ECAs foram selecionados para análise qualitativa, e destes, seis ECAs foram incluídos na meta-análise. Os estudos analisados demonstraram uma redução significativa de VAS associada ao uso de métodos para melhorar a cicatrização de feridas. As estimativas agrupadas revelaram uma redução global significativa do VAS de 2,20 (95% CI 2,32, 2,07) 7 dias após a cirurgia. Os métodos que apresentaram maior redução na percepção de dor foram fibrina rica em plaquetas, ácido hialurônico e cola de fibrina autóloga. Métodos que melhoram a cicatrização de feridas podem reduzir a percepção de dor após a remoção do enxerto gengival livre na região do palato, especialmente fibrina rica em plaquetas, ácido hialurônico e cola de fibrina autóloga. No entanto, apenas um ECA avaliou cada abordagem, o que impossibilita a conclusão sobre qual é o melhor procedimento para reduzir a percepção de dor.

Emerging titanium surface modifications: The war against polymicrobial infections on dental implants

Abstract Dental implants made of titanium (Ti) material is recognized as the leading treatment option for edentulous patients' rehabilitation, showing a high success rate and clinical longevity. However, dental implant surface acts as a platform for microbial adhesion and accumulation once exposed to the oral cavity. Biofilm formation on implant surfaces has been considered the main etiologic factor to induce inflammatory diseases, known as peri-implant mucositis and peri-implantitis; the latter being recognized as the key reason for late dental implant failure. Different factors, such as biofilm matrix production, source of carbohydrate exposure, and cross-kingdom interactions, have encouraged increased microbial accumulation on dental implants, leading to a microbiological community shift from a healthy to a pathogenic state, increasing inflammation and favoring tissue damage. These factors combined with the spatial organization of biofilms, reduced antimicrobial susceptibility, complex microbiological composition, and the irregular topography of implants hamper biofilm control and microbial killing. In spite of the well-known etiology, there is still no consensus regarding the best clinical protocol to control microbial accumulation on dental implant surfaces and treat peri-implant disease. In this sense, different coatings and Ti surface treatments have been proposed in order to reduce microbial loads and control polymicrobial infections on implantable devices. Therefore, this critical review aims to discuss the current evidence on biofilm accumulation on dental implants and central factors related to the pathogenesis process of implant-related infections. Moreover, the potential surface modifications with anti-biofilm properties for dental implant devices is discussed to shed light on further promising strategies to control peri-implantitis.

Resumo Implantes dentários em titânio (Ti) são reconhecidos como principal modalidade terapêutica para a reabilitação oral de pacientes edêntulos, demonstrando uma alta taxa de sucesso e longevidade clínica. No entanto, após inserção no ambiente bucal, os implantes dentários agem como substrato para adesão e acúmulo microbiano. A formação de biofilmes em implantes dentários tem sido considerada o principal fator etiológico para induzir doenças inflamatórias conhecidas como mucosite peri-implantar e peri-implantite, sendo está última reconhecida como principal razão para falha tardia dos implantes dentários. Diferentes fatores têm sido atribuídos por promover o acúmulo microbiano em implantes dentários, levando a uma mudança microbiológica e favorecendo o dano tecidual, como a matriz do biofilme, exposição a carboidratos e interação entre reinos. Esses fatores combinados com a organização espacial de biofilmes, reduzida suscetibilidade microbiana, complexa composição microbiológica e a superfície irregular dos implantes dificultam o controle do biofilme e a morte microbiana. Apesar da etiologia bem conhecida, ainda não há consenso sobre o melhor protocolo clínico para controlar o acúmulo microbiano nas superfícies dos implantes dentários e tratar a doença peri-implantar. Nesse sentido, diferentes coberturas e tratamentos de superfície no Ti têm sido desenvolvidos objetivando a redução dos níveis microbianos e o controle das infecções polimicrobianas em implantes. Portanto, essa revisão crítica objetiva discutir a atual evidência em relação ao acúmulo de biofilmes em implantes dentários e fatores chave relacionados ao processo patogênico das infecções peri-implantares. Além disso, o potencial de alterações de superfícies com propriedades antimicrobianas para implantes dentários é discutido para ressaltar futuras estratégias promissoras no controle da peri-implantite.

Missense Mutations in the CTSC Gene in Saudi Families Segregating Papillon-Lefèvre Syndrome

No abstract available.

Capillary hemangioma of the gingiva in an adult: a rare case report

Objective: We report a case of a 40-year-old female with gingival overgrowth in the right maxillary anterior region which has been excised at a peripheral hospital that caused displacement, mobility of associated teeth and lip incompetency. Case description: A case of recurrent gingival overgrowth in the right maxillary anterior region in a 40-year-old female with associated teeth displacement and mobility and lip incompetency. There was a radiologic evidence of bone loss. Excisional biopsy was carried out and the histologic diagnosis was Capillary Hemangioma. Conclusion: Capillary Hemangioma should be considered as one of the differential diagnosis in cases of gingival overgrowth ofmaxillary anterior region, which mimics pyogenic granuloma

Mandatory HIV testing as a prerequisite for surgical procedures: Perspectives on rights and ethics

Background. Undergoing mandatory HIV testing as a criterion for a surgical or invasive procedure is illegal in Nigeria, and unethical. This includes requesting an HIV test without the consent of the client, and the disclosure of the test results.Objectives. To assess the practice of mandatory HIV testing among health practitioners, andtoexamine HIV testing without consent, and the disclosure of test results to the patient.Methods. This was a cross-sectional survey of both medical doctors and nurses with surgical skills. We used convenience sampling to selectrespondents from Jos University Teaching Hospital, Nigeria and Federal Teaching Hospital, Gombe, Nigeria. A total of 99 respondents filled and returned a questionnaire. Statistical Package for the Social Sciences version 20 was used to manage the data, and the results were presented using descriptive statistics.Results. Over one-third (34.3%) of the respondents reported that they would insist on seeing an HIV test result before performing a surgical or invasive procedure; meanwhile, 4 (4%) of the respondents had refused to render surgical or invasive intervention to HIV clients, while (3%) admitted having refused surgical procedures to patients who refused to take an HIV test. The majority of the respondents (79; 79.8%)reported that the basic equipment and consumables needed for universal precautions were either not available or grossly inadequate.Conclusion. Requests for patients to take an HIV test before surgical procedures are frequent; however, only a few respondents had ever refused to provide a surgical intervention on the basis of a patient's HIV-positive status. Equipment and consumables necessary for universal precautions were either not available or grossly inadequate in the surveyed hospitals

Maxillofacial Trauma of Paediatric Patients: University of Malaya Experience

@#This study aimed to determine the incidence, aetiology, types of injury, management and the outcomes of the treatment of maxillofacial trauma among paediatric patients treated in Faculty of Dentistry, University of Malaya. A retrospective study (2005-2015) was carried out which involved retrieving past records (manual/electronic form) of paediatric patients (under 16 years old) who presented with maxillofacial trauma. Data collected was organized using descriptive statistics with SPSS version 12.0.1. The total number of patients was 120 but only 93 had complete records. The ratio of boys to girls was 2:1. The main cause of injury was falling (54%) followed by motor-vehicle accident (MVA) (42%), assault (3%), and sport (1%). The total count of soft tissue injury only was about 41% while 59% presented with maxillofacial fracture. Midface were the most common fracture occurred followed by mandibular fractures. Both fractures were mostly managed by open reduction and internal fixation (ORIF) using non-resorbable plates except for condylar fractures which were mostly managed conservatively. In conclusion, the incidence of maxillofacial trauma in children increased within the time frame of this study. The most common aetiology was fall. Hard tissue injury accounting for most of the cases whereby midface was the most common site involved. ORIF was the treatment of choice for most of the fracture cases except for condylar fractures (conservative management). All patients had achieved reasonable outcomes postoperatively in terms of form and functions.

Type 2 diabetes mellitus; effectiveness of paid for screening emotional problems of patients affecting adherence and blood glucose level

The study is aimed to assess emotional problem of patients with Type- 2 diabetes by translating and validating PAID. Associations between PAID and blood glucose levels, and differences in prevalence of emotional problems across treatment modalities and BMI. Data was collected from various outpatients of Rawalpindi and Islamabad. The sample of study comprised of 300 patients with diabetes both male = 135 [45%] and female n=165 [55%]. Formal approval was taken from authorities at respective hospitals and after taking informed consent patients were interviewed. Data collection was completed during Feb to April, 2013. Patients were asked to fill in demographic sheet along with Translated PAID scale. Latest blood glucose levels were collected from their medical records whereas BMI was calculated by measuring patients' weight and height. Results showed that emotional problems as assessed by PAID are positively correlated with blood glucose levels [r=.12 to r=.19, p<.05]. Additionally, patients with IV modality of treatment [i.e., taking insulin shots] suffered significantly high [MD=4.88, p=.01] from emotional problems and patients with normal BMI and Obese Class-II have are at higher risk of emotional problem. Finally, patients rated serious concerns on diabetes-related issues like lifelong maintenance, future complications, depression and anxiety, and satisfaction with physician. PAID is a very effective instrument in identifying emotional problems of diabetes patients related to adherence and compliance to their treatment regime and hence it shall be used by physicians and health professional in routine practice

Relationship between resilience and quality of life in diabetics

To determine the relationship between resilience and quality of life of diabetes patients controlling the effect of personal level [i.e., gender, age, and income] and disease-specific [i.e., duration of disease, and current glucose level] demographics. Analytical study. Outpatient Departments of various hospitals in Islamabad and Rawalpindi, from October to November 2012. Patients diagnosed with diabetes taking treatment in an outdoor patients' facility were included. Patients with a major diabetes complications causing or coexistent with a physical disability, medical condition or psychiatric comorbidity were excluded. Informed consent was taken from patients before administration of questionnaires. The patients were asked to respond to a demographic sheet, State-Trait resilience inventory, and WHO-Quality of Life BREF. Statistical testing was conducting using bivariate correlation, Mann-Whitney U-test, and multiple linear regression analysis for moderation testing. There were 242 patients including [n=108, 44% females; and n=134, 56% males] aged 17 - 85 years with mean of 44.56 +/- 16.56 years. Trait resilience predicted all aspects of quality of life of diabetic patients [b range = 0.30 to 0.42, p < .01] and explained 17% variance in physical functioning, 29% in psychological functioning, 17% in environmental functioning, 30% in social dimension, and 29% in overall quality of life. Duration of diabetes moderated effect of state resilience on all aspects of quality of life [b interaction range = 0.20 to 0.26, p < .05] and explained an additional 4% variance in physical functioning, 5% in psychological functioning, 3% in environmental functioning, 5% in social dimension, and 4% in overall quality of life of diabetics. Trait resilience has unconditional positive effect on all aspect of quality of life. Long standing diabetics may benefit from intervention addressing state resilience

Serological markers of inflammatory bowel disease in children from the western region of Saudi Arabia

Serological markers including peri-nuclear anti-neutrophil cytoplasmic antibodies [pANCA] and anti-Saccharomyces cerevisiae antibodies [ASCA] have been reported in relation to inflammatory bowel disease [IBD]. The aim of this study was to ascertain the prevalence and diagnostic accuracy of pANCA and ASCA antibodies in Saudi children with IBD. A retrospective case-control study of children with IBD seen at King Abdulaziz University Hospital, Jeddah, between September 2002 and February 2012. The study included 131 patients with IBD [86 Crohn's disease [CD] and 45 ulcerative colitis [UC]] and 67 non-IBD control subjects. Females comprised 51% of CD, 60% of UC and 52% of non-IBD controls. The mean age was 10.7 +/- 5.2 years for CD, 8.9 +/- 5 years for UC, and 11.2 +/- 6.8 years for the non-IBD controls. Positive ASCA-IgA and ASCA-IgG were detected in 35.8% and 35% of CD patients and in 5.8% and 3.7% of the non-IBD controls, respectively. The pANCA was detected in 28.9% of UC patients and in none of the non-IBD controls. The pANCA recognised the myeloperoxidase [MPO] antibody in 36.4% of the patients with UC. No significant difference in the frequency of pANCA between extensive disease and disease limited to the rectosigmoid colon [p = 0.48], and no significant difference in the ASCAs antibodies in patients with or without involvement of the terminal ileum [p = 0.81]. The prevalence of ASCA and pANCA antibodies was low in Saudi children with IBD. Therefore, it may not be useful as a screening tool for IBD but it may be employed to aid the diagnosis in clinically suspected cases

Prevalence of celiac disease in children with type 1 diabetes mellitus screened by anti-tissue transglutaminase antibody from western Saudi Arabia

To determine the prevalence of celiac disease [CD] in children and adolescents with type 1 diabetes mellitus [T1DM] using anti-tissue transglutaminase [anti-tTG] antibodies. A retrospective hospital record-based study of all children and adolescents with T1DM who were screened for CD was conducted at the Pediatric Diabetes Clinic of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia [KSA] between October 2002 and June 2011. A total of 430 children with T1DM were screened by anti-tTG antibody. The median age at screening was 10.7 years [range; 1.1-18]. The study cohort included 232 [54%] Saudi patients, and females constituted 58.8% of the total number. Anti-tTG antibody screening was positive in 91 [21.2%] patients. Forty-eight [11.2%] out of 430 children screened had biopsy-proven CD. Forty-two patients with CD [87.5%] were asymptomatic. Patients with CD had less weight for age [p=0.007], and height for age [p=0.03] z-scores than non-CD patients. They showed more association with anemia [p<0.001], low albumin level [p<0.001], and autoimmune thyroid disease [p=0.002]. There was no difference in the mean glycosylated hemoglobin level [p=0.38], or insulin requirements [p=0.74] between the 2 groups. The prevalence of CD in patients with T1DM from the Western region of KSA is considered among the highest reported. Therefore, routine screening through proper serological testing is recommended.

Trace elements status in type 2 diabetes.

Background: The metabolism of several trace elements has been reported to alter in diabetes mellitus and these elements might have specific roles in the pathogenesis and progress of this disease. Objective: The aim of the present study was to investigate serum levels of copper, zinc, chromium, magnesium and manganese in type 2 diabetic patients and their possible association with age, glycemic status and duration of diabetes. Methodology: The comparative study included 116 type 2 diabetic patients and 40 non-diabetic subjects. Fasting plasma glucose and HbA1c were determined by the glucose oxidase method and affinity chromatography respectively. The element concentrations were measured by means of an atomic absorption spectrophotometer after microwave-induced acid digestion. Results: Mean (±SD) Mg and Zn levels were significantly reduced in blood samples of diabetic patients as compared to control subjects (p<0.0001-<0.05). The alterations observed in serum levels of copper and manganese was not significant among diabetic and normal subjects. Glycemic status, duration of diabetes and age did not effect the trace elements concentrations. Conclusion: The results confirm that deficiency and efficiency of some essential trace metals may play a role in the development of diabetes mellitus.

Evaluation of stentangioplasty in university cardiac center.

In this ongoing prospective study conducted in University Cardiac Center, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2004 to January 2006. Fifty (50) patients (mean age 56+/-7.2 years) underwent stentangioplasty were evaluated. The study group of 50 patients consisted of 42 (84%) men and 08 (16%) women. The aim of this study was to evaluate in-hospital success, failure and complications during the procedures. About risk factors 19(38%) had hypertension, 13(26%) were smoker, 11(22%) suffered from diabetes mellitus, 05(10%) had family history of ischaemic heart disease. Average left ventricular ejection fraction was 54+/-7. Target vessel percutaneous coronary angioplasty (PTCA) were done in 61 vessel, intracoronary stent implanted in 58 vessels, direct stenting were done in 35 cases, failed PTCA were in 03(6%) cases and two had dissection. The native vessels had a mean reference diameter of 2.91 mm and their luminal diameter increased significantly after percutaneous coronary intervention (PCI). All the patients were discharged by one to three days of the procedure with improvement of their clinical condition. In conclusion, intracoronary stent deployment in coronary artery stenosis following balloon angioplasty is a valid and beneficial strategy with good in-hospital results.

D-Dimer plasma levels in patients with coronary artery disease

We have previously reported that prothrombin fragment 1+2 levels were not associated to the presence or severity of coronary artery disease (CAD) and do not provide further information on subjects with CAD diagnosed by angiography. Thus, in the present study another marker of hypercoagulability was evaluated in the same subjects. This study aimed at determining D-Dimer plasma levels in a group of subjects undergoing coronary angiography to establish a likely relation between this parameter and the severity of CAD. D-Dimer plasma levels were determined in 17 subjects with no coronary atheromatosis (controls), 12 subjects with mild/moderate atheromatosis and 28 subjects with severe atheromatosis. No significant differences were observed among the three groups. Data analysis enables an inference on a tendency towards an increase in fibrinolytic activity in patients with atheromatosis, reflected by the increase in D-Dimer concentrations in the severe atheromatosis group in subjects with CAD diagnosed by coronary angiography.

Em estudo prévio, os níveis plasmáticos do fragmento 1+2 da protrombina não foram associados com a presença ou com a gravidade da doença arterial coronariana (DAC), não trazendo benefício adicional pelo menos em indivíduos com diagnóstico de DAC estabelecido por angiografia. Desta forma, neste estudo outro marcador de hipercoagulabilidade foi avaliado nos mesmos pacientes. O presente estudo teve como objetivo determinar os níveis plasmáticos do dímero D de um grupo de indivíduos submetidos à angiografia coronariana, buscando estabelecer a possível correlação entre este parâmetro e a gravidade da DAC. Os níveis plasmáticos do dímero D foram determinados em amostras de sangue de 17 indivíduos com ausência de ateromatose nas coronárias (controles), 12 indivíduos apresentando ateromatose leve/moderada e 28 indivíduos apresentando ateromatose grave. Não foram encontradas diferenças estatisticamente significativas entre as médias dos três grupos para o parâmetro avaliado. Uma análise dos dados permite inferir sobre uma tendência ao aumento da atividade fibrinolítica nos pacientes com ateromatose, refletida pela elevação da concentração de dímero D no grupo ateromatose grave em indivíduos com diagnóstico de DAC estabelecido por angiografia coronariana.

Serum concentrations of interleukin-1 alpha, interleukin-6 and tumor necrosis factor-alpha in neonatal sepsis and meningitis

To investigate whether serum levels of interleukin-1alpha [IL-1alpha], IL-6, tumor necrosis factor alpha [TNF-alpha], C-reactive protein [CRP] are useful in the diagnosis of neonatal sepsis and meningitis and differentiate them. Blood samples were collected from 35 full term neonates with suspected infection who admitted to the Neonatology Unit, Pediatric Department, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia during January 2002 - June 2003. On the basis of laboratory and bacteriological results, newborns were classified into: sepsis [n=28], meningitis [n=7], and healthy controls [n=16]. Sepsis groups were further subdivided according to culture results into: group 1 = proven sepsis [n=6], group 2 = clinical sepsis [n=14], and group 3 = possible-infected [n=8]. Serum levels of IL-1alpha, IL-6, TNF-alpha were measured using Enzyme-Linked Immunosorbent Assay while CRP by nephelometer. In sepsis and meningitis patients, serum levels of CRP [p<0.01, p<0.05,] and IL-1alpha [p<0.001, p<0.05] were elevated than controls. C-reactive protein levels elevated in proven sepsis [p<0.001] and IL-1alpha elevated in all subgroups of sepsis [groups 1, 2, 3] compared with [p<0.05, p<0.001, p<0.01] controls. Interleukin-6, TNF-alpha showed no significant differences between studied groups. In sepsis and meningitis, IL-1alpha had a highest sensitivity [89%, 86%], and negative predictive values [89% and 93%]. Interleukin-1alpha and CRP increased in neonatal sepsis and meningitis, but cannot differentiate between them. Interleukin-1alpha had a highest sensitivity in prediction of neonatal infection and its assessment may improve accuracy of diagnosis

Fragmento 1+2 da protrombina em indivíduos submetidos à angiografia coronariana / Prothrombin fragment 1+2 in subjects undergoing coronary angiography

A trombina exerce um papel fundamental na conversão do fibrinogênio em fibrina, no processo de coagulação. O fator X ativado transforma a protrombina em trombina e fragmento 1+2 da protrombina (F1+2). Os níveis plasmáticos de F1+2 refletem a geração de trombina e podem ser usados como um marcador de hipercoagulabilidade in vivo, já que a trombina é uma substância instável e facilmente degradada, que não pode ser medida diretamente no plasma. O presente estudo teve como objetivo determinar os níveis plasmáticos do F1+2 de um grupo de indivíduos submetidos à angiografia coronariana, buscando estabelecer a possível correlação entre este parâmetro e a gravidade da doença arterial coronariana (DAC). Os níveis plasmáticos do F1+2 foram determinados em amostras de sangue de 17 indivíduos com ausência de ateromatose nas coronárias (controles), 12 indivíduos apresentando ateromatose leve/moderada e 28 indivíduos apresentando ateromatose grave, utilizando-se o conjunto diagnóstico Enzignost F1+2 (Behring® Diagnostics GmbH, Marburg, Germany). Não foram encontradas diferenças estatisticamente significativas entre as médias dos três grupos para o parâmetro avaliado. Portanto, as médias obtidas nos três grupos para os níveis plasmáticos de F1+2 não sinalizam para a existência de um estado de hipercoagulabilidade na população estudada. Entretanto, 73,7 por cento dos indivíduos faziam uso regular de ácido acetilsalicílico, o que pode ter influenciado nos resultados de F1+2, uma vez que este medicamento promove a inibição da enzima ciclooxigenase, diminuindo a liberação de tromboxane A2 e a agregação plaquetária. Portanto, presume-se que a redução da ativação plaquetária poderia estar contribuindo para uma menor formação de trombina e, conseqüentemente, diminuindo o potencial de hipercoagulabilidade.

Thrombin plays a basic role in the conversion of fibrinogen to fibrin in the coagulation process. Activated factor X transforms the prothrombin into thrombin and breaks up prothrombin fragment 1+2 (F1+2). F1+2 plasma levels reflect the thrombin generation and can be used as in vivo markers of hypercoagulability since the thrombin is an unstable and easily degraded substance that cannot be directly measured in the plasma. The present study aims at determining the F1+2 plasma levels of a group of subjects undergoing coronary angiography, attempting to establish a possible correlation between this parameter and the severity of the coronary artery disease. F1+2 plasma levels were determined in blood samples of 17 subjects with absence of atheromatosis in coronary arteries (controls), 12 subjects presenting mild/moderate atheromatosis and 28 subjects presenting severe atheromatosis, using the Enzignost F1+2 (Behring® Diagnostics GmbH, Marburg, Germany) diagnostic Kit. Significant differences between the averages for the three groups in respect to the evaluated parameters were not found. Therefore, F1+2 plasma level averages for the three groups did not point to a state of hypercoagulability in the studied population. However, 73.7 percent of the individuals were taking acetylsalicylic acid, which may have influenced the F1+2 plasma levels, considering that this medicine promotes the inhibition of the enzyme cyclo-oxygenase, diminishing the release of thromboxane A2 and the platelet aggregation. Therefore, it is presumed that platelet activation reduction could be contributing to a lower formation of thrombin and, consequently, diminishing the hypercoagulability potential.

Pneumatosis cystoides intestinalis with pyloric stenosis: a rare clinical entity

Pneumatosis cystoides intestinalis [PCI] is a relatively rare condition characterized by multiple intramural pockets of gas involving any portion of the gut. In this case, report pyloric stensosis associated with pneumatosis cystoides intestinalis is presented

Tuberculous colo-appendicular fistula

A case of tuberculous fistula between the appendix and sigmoid colon is being presented. Appendicectomy with resection of the part of sigmoid colon having the fistula was performed. Histopathology report of the appendix and mesenteric lymph nodes revealed chronic granulomatous appendicitis and lymphadenitis with caseation. To the best of our knowledge it has not been reported in literature before

Mineral and parathyroid hormone inter-relationships in normal pregnancy and pregnancy-induced hypertension

The serum of calcium, other involved minerals and parathyroid hormone [PTH] were studied in non-pregnant women, during pregnancy and in pregnancy-induced hypertension [PIH]. In pregnant women, serum creatinine, total calcium, total protein, albumin, inorganic phosphorus and magnesium declined, while parathyroid hormone levels increased significantly when compared to non-pregnant women. In PIH cases, serum total proteins, albumin and inorganic phosphorus were further reduced, while PTH levels were further increased when compared to normal pregnant women. Serum ionised calcium and sodium levels were similar in all the three groups. No significant relationship between blood pressure, PTH and involved minerals was observed in this study