Oral health-related quality of life: acrylic versus flexible partial dentures

Background: Teeth lost are usually replaced by all-acrylic removable partial dentures (RPD) because of its affordability and ease of fabrication. The all-acrylic RPD is said to cause significant periodontal injury and consequently affect the oral health related quality of life (OHRQoL) of denture wearers. Objective: To determine and compare OHRQoL of all-acrylic and flexible RPD wearers at baseline and after use of dentures. Design and setting: Study was quasi-experimental using a cross-over design, involving 30 patients with Kennedy class IV and anterior class III arches. Patient recruitment and review were done over an eight-month period in the Prosthetic Unit of a tertiary health facility. OHRQoL was assessed with the oral health impact profile-14 questionnaire. Data were analysed using descriptive and multivariate analysis at asignificant level of p <.05. Results: Mean age of patients was 33.8 ±10.0 years; at baseline, patient reported occasionally, fairly often or very often for 11(78.6%) OHIP items. However, after using the acrylic and flexible partial dentures, 11(36.6%) patients reported having trouble pronouncing words and 9(30.0%) found it uncomfortable to eat respectively. At baseline, there was a difference in mean OHIP scores with age (p=.02); scores reduced from 12.4 ± 9.8 to 4.8±5.3 (CI= 3.3­ 12.0, p=.001) after using the all-acrylic denture and 3.8±5.6 (CI= 4.3­13.0, p<.001) with the flexible denture. Conclusion: There was improvement in the OHRQoL of patients with use of flexible partial dentures. Therefore, thermoplastic materials are possible alternative RPD base materials in patient management

Global Cassava Food Supply and Occurrence of Ataxic Polyneuropathy and Konzo.

Study was done to describe global cassava food supply, and its relationship to occurrence of ataxic polyneuropathy and konzo, which are attributed to exposure to cyanide from cassava food. Cassava food supply and occurrence of ataxic polyneuropathy and konzo in all countries from 1961 to 2011, and GDP data for 2011 were analyzed. Cassava food supply ≥ 10% of expected daily calorie need was compared with GDP and occurrence of ataxic polyneuropathy and konzo. About half a billion people live where cassava food supply was ≥180 kcal/person/day. Cassava food supply ≥180 kcal/person/day was associated with GDP per capita ≤$535, p<0.0001, and with occurrence of ataxic polyneuropathy or konzo, odds ratio 30 (95% CI 7–134). Strong association of high cassava supply with low income and with endemicity of ataxic polyneuropathy and konzo indicates that reduction of contribution of cassava to energy needs will reduce the burden of disease.

Traditional and nontraditional cardiovascular risk factors in women with active rheumatoid arthritis: relation to disease activity

Cardiovascular event rates are markedly increased in rheumatoid arthritis [RA], and RA atherogenesis remains poorly understood. The relative contributions of traditional and nontraditional risk factors to cardiovascular disease [CVD] in RA await elucidation. To compare traditional and nontraditional cardiovascular risk factors in RA patients Vs age and sex-matched healthy control population and in seropositive Vs seronegative RA patients and to correlate these potential risk factors with the disease duration and activity. Thirty nine active RA women were divided according to the presence or absence of rheumatoid factor into two groups and twenty nine age- and sex-matched apparently healthy control women. After controlling for age and menopausal status, traditional cardiovascular risk factors including body mass index [BMI], waist circumference, hypertension, fasting lipids [Triglycerides [TG], Total cholesterol [TC], Low density lipoprotein cholesterol [LDL-C] and High density lipoprotein cholesterol [HDL-C]], and insulin sensitivity [IS], and nontraditional cardiovascular risk factors, including high-sensitivity C-reactive protein [hs-CRP], IL-1, IL-6 and tumor necrosis factor-a were compared in RA patients versus healthy control individuals and in seropositive versus seronegative RA patients. Insulin sensitivity was determined by the Quantitative Insulin Sensitivity Check Index [QUICKI]. Traditional and nontraditional risk factors for CVD were correlated with disease duration and activity. Rheumatoid factor was positive in twenty six [67%] of RA patients. Significant higher percentage of individuals with hypertension [p<0.05], significant lower levels of HDL-C and QUICKI [p<0.001, <0.05 respectively] and significant higher levels of LDL-C and hs-CRP, IL-1, IL-6 and TNF-a concentrations [p<0.05, 0.001, 0.001, 0.001 and 0.001 respectively] were observed in RA patients Vs controls. Significant lower HDL-C [p<0.05] and higher hs-CRP, and IL-6 concentrations [p<0.01, 0.05 respectively] were observed in seropositive Vs seronegative RA patients. No correlation was found between traditional and nontraditional risk factors for CVD and duration of disease. HDL-cholesterol, hs-CRP, Interleukin -1 and Interleukin -6 correlated significantly with disease activity score [p<0.05, <0.01, <0.05 and <0.02 respectively]. Excess traditional and nontraditional cardiovascular risk factors were observed in RA patients as compared with controls and in seropositive RA patients as compared with seronegative RA patients. This results in a tendency towards increased frequency of CV death in RA patients, more commonly in seropositive patients. Non-traditional risk factors play a more important role than traditional risk factors in cardiovascular disease in RA

Association of interstitial pulmonary fibrosis and rheumatic disorders in chronic hepatitis c virus infection patients

To investigate the association of idiopathic pulmonary fibrosis [IFF] and rheumatological disorders in patients with chronic hepatitis C virus [HCV] infection via clinical laboratory and radiological studies. Fifty one patients, 36 males and 15 females, with documented HCV and 25 healthy subjects, 18 males and 7 females, were enrolled in the study. Clinical examination, laboratory investigations [biochemical, virological and immunological] and plain chest X-ray [CXR], high resolution computed tomography [HRCT] and pulmonary function tests [PFT] were performed in all subjects. The presence of arthralgia, myalgia, fibromyalgia, polymyositis [PM], type II mixed cryoglobulinaemia [MC], purpura, and Raynaud's phenomenon and pulmonary fibrosis, were observed in 8/51, 10/51, 4/51, 5/51, 9/51, 2/51, 1/51 and 9/51 of HCV-positive patients, respectively. The presence of high serum creatinine kinase [CK], RF, ANA, complement-4 [C4] reduction and Anti-Jo-1 antibodies were observed in 5/51,5/51, 2/51, 3/51 and 3/51 of HCV-positive patients, respectively. There was a significant difference between controls and patients with HCV for the presence of arthralgia, myalgia, polymyositis, type II MC and IFF on HRCT [p<0.01, <0.01, <0.05, <0.01 and <0.01 respectively]. Pulmonary fibrosis was found in 3/5 and 5/9 patients with polymyositis and type II MC respectively. HRCT findings of IFF consisted of nodular areas of high attenuation, ground-glass attenuation, consolidation, septal lines, non-septal lines, and honeycombing in 6/51, 2/51, 1/51, 2/51, 4/51, and 1/51 patients with HCV, respectively. Our nine patients with interstitial pulmonary involvement had HRCT scores consistent with mild parenchymal abnormalities in 3, moderate in 5 and severe in one patient. Only one case in the controls [1/25] had ground-glass attenuation on HRCT. PFT abnormalities were present in only 13 patients [-26%]. PFT measurements revealed that VC, FVC, FEV1, and FEF25-75 were below 80% of the predicted value in 10/51, 11/51, 8/51 and 16/51 patients with HCV, respectively. DLCO was decreased in 21/51 patients. However, there was no significant difference between controls and patients with HCV infection in mean PFT parameters. No correlation was found among HRCT features and PFT abnormalities. The results of this study suggest that chronic HCV infection appears to be involved in the pathogenesis of rheumatic diseases and pulmonary fibrosis. An association between interstitial lung disease [ILD] and polymyositis and/or type II mixed cryoglobulinemia seems to occur frequently in patients with chronic HCV infection. HRCT provides a sensitive and noninvasive technique than PFTs for detecting pulmonary involvement in HCV despite absence of symptoms, normal chest radiograph, and normal pulmonary function testing

Role of lipase in glucose and lipid metabolisms

To investigate the role of lipase in glucose and lipid metabolisms. A prospective study involving 52 diabetics [28 males and 24 females, mean age 47.67 +/- 15.63 years] and 118 normoglycemic controls [39 males and 79 females, mean age 38.91 +/- 16.61 years] was conducted, between February 1st and August 31st, 2006, at King Abdullah Hospital, Bisha, Saudi Arabia. After 10-12 hours fasting, blood was taken from subjects and controls for the determination of glucose, total cholesterol, triglyceride, low-density lipoprotein [LDL]-cholesterol, high density lipoprotein [HDL]-cholesterol, and lipase. The results were analyzed by student's t-test and Pearson correlation coefficient. The levels of glucose, total cholesterol, triglyceride, LDL-cholesterol, and lipase were significantly more in the diabetics [p<0.05]. However, HDL-cholesterol was less in the diabetics than the controls, although the difference was not significant [p>0.05]. There were significant positive correlations between glucose, total cholesterol, triglyceride, and lipase; while, significant negative correlations were obtained between LDL-cholesterol, HDL-cholesterol, and lipase. The higher concentrations of glucose, total cholesterol, triglyceride, and LDL-cholesterol, as well as the lower HDL-cholesterol in the diabetics were typical and not unexpected, as diabetes mellitus is associated with disturbance of lipid metabolism. The lipase activity was elevated at increased concentrations of glucose and lipids. Hence, it was concluded that the pancreatic lipase was possibly involved in the metabolisms of both glucose and lipids. Lipolysis has been suggested as the link between the 2 processes