Dentoalveolar effects of skeletally anchored extrusion arch in anterior open bite patients: A prospective clinical trial

ABSTRACT Objective: The purpose of this prospective clinical trial was to explore the dental and soft tissue changes accompanying the use of skeletally anchored nickel-titanium (NiTi) extrusion arch in the correction of anterior open bite (AOB). Material and Methods: Twenty female patients with a mean age of 16.5 ± 1.5 years and a mean dentoalveolar AOB of 2.38±0.7 mm participated in this study. All patients were treated with an maxillary 0.017×0.025-in NiTi extrusion arch, with the aid of miniscrews inserted between the maxillary second premolars and first molars bilaterally, to act as indirect anchorage. Three-dimensional digital models and lateral cephalometric radiographs were taken just before the insertion of the extrusion arch (T0) and after 10 months (T1). Paired-sample t-tests were used in analyzing the data, to evaluate the changes after treatment (T1-T0). A significance level of p < 0.05 was used. Results: AOB was successfully closed in all patients, with a 4.35 ± 0.61 mm increase in the overbite. Maxillary incisors significantly extruded (2.52 ± 1.02 mm) and significantly reclined (5.78 ± 0.77°), with a resultant decrease in the overjet of 1.58 ± 0.5mm. A significant intrusion of maxillary first molars with no change in their inclination was observed. The upper lip showed a significant retraction tendency to the E-plane, and a significant increase in the nasolabial angle was observed. Conclusion: The skeletally anchored NiTi extrusion arch was an effective technique in treating AOB, with no adverse effects on the molars.

RESUMO Objetivo: O objetivo deste ensaio clínico prospectivo foi avaliar as alterações dentárias e em tecidos moles que acompanham o uso de arco de extrusão de níquel-titânio (NiTi) com ancoragem esquelético na correção da mordida aberta anterior (MAA). Material e Métodos: Participaram deste estudo 20 pacientes do sexo feminino com idade média de 16,5 ± 1,5 anos e MAA dentoalveolar (média de 2,38 ± 0,7 mm). Todos os pacientes foram tratados com arco de extrusão de NiTi 0,017×0,025" superior, com auxílio de mini-implantes inseridos entre os segundos pré-molares e primeiros molares superiores bilateralmente, para atuar como ancoragem indireta. Modelos digitais tridimensionais e radiografias cefalométricas laterais foram realizados imediatamente antes da inserção do arco de extrusão (T0) e após 10 meses (T1). Testes t para amostras pareadas foram utilizados na análise dos dados, para avaliar as alterações após o tratamento (T1-T0). Um nível de significância de p< 0,05 foi usado. Resultados: A MAA foi fechada com sucesso em todos os pacientes, com aumento de 4,35 ± 0,61 mm na sobremordida. Os incisivos superiores foram significativamente extruídos (2,52 ± 1,02 mm) e significativamente reclinados (5,78 ± 0,77°), com uma consequente diminuição na sobressaliência de 1,58 ± 0,5 mm. Foi observada intrusão significativa dos primeiros molares superiores, sem alteração na sua inclinação. O lábio superior apresentou tendência significativa de retração em relação ao plano E, e foi observado aumento significativo do ângulo nasolabial. Conclusão: O arco de extrusão de NiTi esquelético foi uma técnica eficaz no tratamento da MAA, sem efeitos adversos nos molares.

Comparison of the effect of nitroglycerin, magnesium sulphate and dexmedetomidine as hypotensive agents in lumbar spine surgery

Background: in orthopedic procedures more blood is lost from raw bone and muscle surface than from identifiable blood vessels. Moderate hypotensive anesthesia was found to significantly decrease the average blood loss by nearly 40%, reduce the need for transfusion by 45% and shorten the average operating time by nearly 10%. Objective: The aim of the current study was to compare magnesium sulphate and dexmedetomidine with nitroglycerin as regard hypotensive effect as primary outcome, volume of blood loss, blood substitution and pattern of recovery as secondary outcome during lumbar spine surgery. Patients and Methods: This prospective, controlled, comperative, randomized, double blind study included a total of ninty patients aged 21-50 years of both sex, ASA I-II scheduled for elective lumber spine surgery, attending at Department of Orthopedic, AL-Azher university Hospital in Assuit as single center study. Patients have received either dexmedetomidine, magnesium sulfate or nitroglycerine. Results: There were highly significant difference (P <0.000) with duration of surgery between different study groups with duration of surgery shortest in dexmedetomidine group followed by magnesium sulfate group and then nitroglycerine group. There were highly significant differences between different study groups with fluid maintenance with higher volume in nitroglycerine group then magnesium sulfate group and then dexmedetomidine group. There were highly significant differences (P <0.000) with systolic blood pressure between study groups at A1 and hypotensive agent discontinuation with lowest systolic blood pressure in dexmedetomidine group followed by magnesium sulfate group and then nitroglycerine group. Conclusion: nitroglycerine, magnesium sulfate and dexmedetomidine could induce hypotension, but dexmedetomidine showed more favorable hemodynamic profile as regard blood pressure and heart rate

Role of electrocardiogram-gated multidetector computed tomography in diagnosis of congenital heart disease

Aim of the work: this study aimed to assess the role of ECG gated multidetector computed tomography in detection and characterization of congenital heart diseases

Patients and method: this study was carried out in the Radiology Department of Ain Shams University Hospitals. A total of 30 patients presented with clinically/echocardiographically known to have congenital heart disease. They were 17[56.7%] females and 13 [43.3%] males. Their age was ranged from 3 days -18 year old

Results: Regarding the cardiac abnormalities, we found good agreement between Echo and ECG gated MDCT as regard cardiac abnormalities with kappa value measuring 0.771. Regarding great vessels anomalies, we found overall good agreement between Echo and MDCT where k measuring 0.790. As regard extracardiac findings, lung changes that were seen in MDCT only in form of lung consolidation in three cases [10%] and one case of unilateral lung hypoplasia [3.3 %]

Conclusion: ECG gated MDCT is considered as an essential non-invasive diagnostic tool for the evaluation of congenital cardiac and extra cardiac great vessels. MDCT is complementary to the cardiac echocardiography especially in complex heart abnormalities

Head and neck cancer association to CIAP-2 expression due to human papillomavirus-16 [HPV-16] infection

It was relevant to assess the impact of a HPV-16 [human papillomavirus-16] which is a high-risk genotype on head and neck cancers and its relation to CIAP-2 expression [Cellular Inhibitor of apoptosis-2]. Tissue samples were taken from patients diagnosed as head and neck cancer. All samples were subjected to qualitative polymerase chain reaction [PCR] analysis for HPV, qualitative and semi-quantitative reverse transcription polymerase chain reaction [RT-PCR] of CIAP-2. There was a significant association between HPV-16 and CIAP2 positivity and head and neck tumors. CIAP-2 expression in malignant tissues was highly associated with HPV-16 infection at sensitivity 73.9% and absolute specificity

Comparative study between electroencephalographic EEG in relatives of idiopathic epilepsy and normal population

The aim of the present work is to study the EEG changes in relatives of idiopathic epilepsy compared with that in a sample of normal population. The study included two groups; Group I consists of 100 relatives of patients with idiopathic epilepsy collected from the Epilepsy Center in EL-Hadara University Hospital and Group II consists of 100 normal subjects with no family history of epilepsy. The relatives in group I were further divided into 4 subgroups according to the type of epilepsy of their epileptic relatives; generalized tonic clonic type [GTC], complex partial type [CP], juvenile myoclonic epilepsy type [JME] and Lennox gastout type [LG]. Both groups were subjected to: Thorough history taking including: age, history of epilepsy, detailed family history of epilepsy, the degree of kinship and the type of epilepsy. Relatives with general medical problems including renal diseases, hepatic disorder, history of neurological deficits, intake of drugs depressing central nervous system were excluded from the study. Both groups were submitted to: Complete general and neurological examination, laboratory investigations included the following: Complete blood picture, Fasting blood glucose, Liver transaminase enzymes. [ALT, AST], Renal function tests [serum creatinine, blood urea], Erythrocytic sedimentation rate and Serum calcium. EEG study: EEG examination was performed by [10-20 system] under standard conditions with different provocation methods as hyperventilation, photic stimulation and sleep deprivation. The results of the study showed that: Pathological EEG changes, in the form of spikes, sharp waves or spike and slow waves complexes were present in 34 out of 100 subjects [34%] of group I, on the other hand only 9 subjects of group II [9%]. The difference was statistically highly significant. [P<0.0001]. Studying the relation of EEG changes and types of epilepsy showed that the percentage of subjects with positive EEG changes in LG group 5 [83.3%] was statistically higher than those in the other 3 subgroups GTC, CP and JME 18[31.0%], 8[30.8%] and 3[30.0%] respectively. Comparing the percentage of generalized EEG changes in relatives of GTCs patients [88.9%] to that of partial EEG changes in the same group [11.2%] was statistically significant [P=0.001]. The comparison of the percentage of partial EEG changes in relatives of CP patients [75.0%] to that of generalized EEG changes in the same group [25.0%], was statistically significant [P<0.001]. Genetics play an important role in idiopathic epilepsy, with variations among its subtypes