Mandibular shape prediction using cephalometric analysis: applications in craniofacial analysis, forensic anthropology and archaeological reconstruction / 대한악안면성형재건외과학회지

Background@#The human mandible is variable in shape, size and position and any deviation from normal can affect the facial appearance and dental occlusion. @*Objectives@#The objectives of this study were to determine whether the Sassouni cephalometric analysis could help predict two-dimensional mandibular shape in humans using cephalometric planes and landmarks. @*Materials and methods@#A retrospective computerised analysis of 100 lateral cephalometric radiographs taken at Kingston Hospital Orthodontic Department was carried out. @*Results@# @*Results@#showed that the Euclidean straight-line mean difference between the estimated position of gonion and traced position of gonion was 7.89 mm and the Euclidean straight-line mean difference between the estimated position of pogonion and the traced position of pogonion was 11.15 mm. The length of the anterior cranial base as measured by sella-nasion was positively correlated with the length of the mandibular body gonion-menton, r = 0.381 and regression analysis showed the length of the anterior cranial base sella-nasion could be predictive of the length of the mandibular body gonion-menton by the equation 22.65 + 0.5426x, where x = length of the anterior cranial base (SN). There was a significant association with convex shaped palates and oblique shaped mandibles, p = 0.0004. @*Conclusions@#The method described in this study can be used to help estimate the position of cephalometric points gonion and pogonion and thereby sagittal mandibular length. This method is more accurate in skeletal class I cases and therefore has potential applications in craniofacial anthropology and the ‘missing mandible’ problem in forensic and archaeological reconstruction.

Mandibular shape prediction using cephalometric analysis: applications in craniofacial analysis, forensic anthropology and archaeological reconstruction / 대한악안면성형재건외과학회지

Background@#The human mandible is variable in shape, size and position and any deviation from normal can affect the facial appearance and dental occlusion. @*Objectives@#The objectives of this study were to determine whether the Sassouni cephalometric analysis could help predict two-dimensional mandibular shape in humans using cephalometric planes and landmarks. @*Materials and methods@#A retrospective computerised analysis of 100 lateral cephalometric radiographs taken at Kingston Hospital Orthodontic Department was carried out. @*Results@# @*Results@#showed that the Euclidean straight-line mean difference between the estimated position of gonion and traced position of gonion was 7.89 mm and the Euclidean straight-line mean difference between the estimated position of pogonion and the traced position of pogonion was 11.15 mm. The length of the anterior cranial base as measured by sella-nasion was positively correlated with the length of the mandibular body gonion-menton, r = 0.381 and regression analysis showed the length of the anterior cranial base sella-nasion could be predictive of the length of the mandibular body gonion-menton by the equation 22.65 + 0.5426x, where x = length of the anterior cranial base (SN). There was a significant association with convex shaped palates and oblique shaped mandibles, p = 0.0004. @*Conclusions@#The method described in this study can be used to help estimate the position of cephalometric points gonion and pogonion and thereby sagittal mandibular length. This method is more accurate in skeletal class I cases and therefore has potential applications in craniofacial anthropology and the ‘missing mandible’ problem in forensic and archaeological reconstruction.

High Incidence of Cough among Users of Angiotensin-Converting Enzyme Inhibitors

Objective: To evaluate the incidence of cough among patients newly diagnosed with hypertension initiated on Angiotensin-Converting Enzyme Inhibitors [ACEI]

Design: A Prospective Study

Setting: Two primary healthcare centers, Bahrain

Method: Newly diagnosed patients with hypertension who were initiated on ACEI or angiotensin receptors blockers [ARBs] were included in the study. The patients were followed for one year starting from 2 January 2016 to 31 December 2016. The following data were documented: age, sex, smoking, body mass index [BMI], and concomitant co-morbid diseases, the onset of cough, duration, drug discontinuation, and the cough disappearance after discontinuation

Result: Eighty patients were included in the analysis. Sixty-five [81%] patients received ACEI and 15 [19%] were on ARBs. Forty-three patients (54%) were females. Cough developed in 24 [37%] patients. Perindopril was the only ACEI prescribed. The mean cough onset is 12.7 days. After stopping or changing the drug, the mean for cough disappearance was 13.3 days. There was a statistically significant gender difference in ACEI-induced cough. Cough developed in 17 [70.8%] females compared to 7 [29.2%] males; P=0.044. There was no significant difference regarding age [P=0.79] or BMI [P=0.37]

Conclusion: The incidence of cough is unexpectedly high among our newly diagnosed hypertensive patients initiated on Perindopril. It is much higher among females. Larger study is needed to examine this common, often intolerable, adverse effect

Lipohypertrophy among insulin-treated patients

Objective: To evaluate insulin injection practice, prevalence and risk factors of lipohypertrophy [LH] among insulin-treated patients

Design: A Retrospective Study

Setting: Two Primary Health Centers, Bahrain

Method: Ninety-five insulin-treated patients were included in the study from 3 January 2016 to 31 May 2016. The following data were documented: age, sex, educational level, type of diabetes, duration of diabetes, duration of insulin treatment, number of injections, type of insulin, daily insulin dose, needle size, site of injection, frequency of needle change, frequency of injection site rotation and frequency of checking the injection site. Diabetes control and Body Mass Index [BMI] were documented. Ultrasound examination of the injection site was performed

Result: Ninety-five insulin-treated patients were included in the study

Thirty-five [36.8%] patients had LH. Seventy-two [75.8%] patients were obese females with poorly controlled type 2 diabetes

Forty-seven [49.5%] patients were using insulin for less than five years. Ninety-three [97.8%] patients were using <6 mm needle; 85 [89.5%] were using the needle once at a time and were doing daily rotation

The injection site was never checked in all except one [1.1%] patient

There was a highly significant statistical association between LH and level of education, the number of injections and the site of injection. Mean subcutaneous fat thickness were 12.3 mm [arm], 17.8 mm [thigh] and 23.3 mm [abdomen]

Conclusion: Lipohypertrophy is prevalent among our patients and could be related to improper insulin injection technique and lack of regular check of the injection sites. Therefore, patients and health providers' education is necessary to reduce its prevalence

Control of cardiovascular risk factors among people with diabetes: evaluation revisited

Objective: To assess control of hyperglycemia, hypertension and dyslipidemia among patients attending diabetes clinic in 2014 compared to 2005

Design: A Cross-Sectional Study

Setting: Primary Health Center, Ministry of Health, Bahrain

Method: Medical records of patients attending diabetes clinic from 1 September 2014 to 31 December 2014 were reviewed. Data documented were age, sex, diabetes duration, Body Mass Index [BMI], smoking, glycated hemoglobin [A1C], oral hypoglycemic drugs and insulin regimen, blood pressure, antihypertensive drugs, lipids profile and statin type

Result: Three hundred seventy patients' records were reviewed. One hundred-thirty [35.1%] patients were males. Two hundred four [55.1%] patients were having diabetes for more than or equal to 15 years. Glycated hemoglobin < 53 mmol/l was achieved in 92 [24.9%] patients in 2014 compared to 134 [20.4%] patients in 2005 [P-Value=0.1]. Blood pressure

Conclusion: Significant improvements have been observed in control of the studied CV risk factors in 2014. However, control of hyperglycemia remains a challenge and needs to be improved

basics of echocardiography

Cardiac echocardiography is becoming an essential diagnostic tool for a variety of cardiac pathology. Acquiring the necessary knowledge will help non cardiac and the cardiac specialist to understand the echocardiography images and reports and in return will improve the care of the patients. The aim of these of publication is to address the basic knowledge of cardiac echocardiography and the recent advances of its applications

Microradiogrphy assesment of unit-dose dispensing system fluoride varnish

Previous studies have shown the effect of using fluoride varnishes both in vivo and in vitro. Re-cently they became presented in different delivery forms. In this in vitro study we asses a new unit-dose delivery system fluoride varnish, comparing it with the standard tube delivery method, and a control group with no varnish application using micro-radiographic technique. Artificial enamel lesions were formed on a group of carefully selected teeth -following certain criteria- in which a window 1x4 mm was left exposed. After lesion formation, parts of the windows were covered by acid-resistant varnish to provide the starting characteristics of the lesions. Then teeth were divided into three groups: Group I control group was exposed to a pH cycling for 7 days without any treatment, Group II was exposed to the same condition as group I with application of standard fluoride delivery system [tube], group III was exposed to the same condition as first group with the application of the unite-dose delivery system. In varnish treatment groups, varnishes were applied and left to dry for five minutes and left on the teeth for at least four hours in de-ionized water. Varnish was then removed by thorough brushing, and teeth went through the pH-cycling for 7 days. Then teeth were sectioned and examined using Micro-radiography. Results showed that the percentage change in lesion area AZ was 19.63 +/- 25.62, -5.62 +/- 18.1, , -18.08 +/- 38.61 for groups I, II, III respectively. The minus values indicate remineralization. Only unit-dose system was significantly different at p<0.05 from the control group when results was analyzed using ANOVA

Case study: undiagnosed diabetic child presented with paretic noncomitant esotropia

The prevalence of type II diabetes in adults is increasing. Superimposed on that are the recent reports of the emerging problem of type II diabetes in children and adolescents. Paretic [noncomitant] esotropia, usually a result of palsy of the abducens nerve is most often seen in adults who have had cerebrovascular accidents or diabetes due to infarction, but it is rarely reported in children. It is of sudden onset and the prognosis is good since most patients recover after a period of weeks to months. A case of undiagnosed diabetic child who presented to primary health care clinic with sudden onset of abducent nerve paresis is described with the main objective of raising the awareness of primary care physician about the increasing prevalence of type II diabetes in children and their unusual presentations. The patient was very obese [BMI = 30.5] with RBS of more than 22 mmol/L and marked glucosuria, with no evidence of ketosis

Serum carbohydrate antigen 125 [CA 125], thymidine kinase [TK] and haptoglobin in acute childhood leukemia and lymphomas: significant markers in the diagnosis, prognosis therapy monitoring and prediction of biochemical relapses

Serum carbohydrate antigen 125 [CA125], Thymidine-Kinase [TK] and Haptoglobin were studied in 35 cases of acute lymphoblastic leukemia [ALL], 15 cases of acute non lymphoblastic leukemia [ANLL], 30 cases of non-Hodgkin lymphoma [NHL], 10 cases of Hodgkin lymphoma [HL], 20 cases of nonmalignant lymphadenopathy [NML] and 15 healthy controls. Significantly higher serum levels of the studied parameters were observed in all malignant disease groups studied before treatment than both control group and the group of benign lymphadenopathy. Cases with abdominal NHL showed significantly higher levels of serum CA125 than either head and neck or mediastinal NHL. Serum CA125 showed the highest sensitivity and specificity in diagnosing cases of NHL, while TK showed the highest sensitivity and specificity in diagnosing cases of either ALL or ANLL. After induction of remission, all studied, malignant groups showed significantly higher serum levels of the studied parameters than par therapy serum levels. Significantly, higher serum levels of CA125, TK and Haptoglobin were observed in all of the studied malignant disease groups before clinical and/or hematological relapse than controls by a period that ranged from 2 to 6 months [Biochemical relapse]. Significantly, higher levels of the studied parameters were observed in C N S involvement by leukemia than in cases without C N S involvement. The studied parameters CA125, TK and Haptoglobin appeared to be useful markers in the diagnosis, prognosis and therapy monitoring of acute childhood leukemias and lymphomas. They are useful markers to detect relapse of cases of ALL, ANLL, NHL and HL

effect of immediate and delayed activation on bond strength of two different self etching primer adhesives to ground enamel

The purpose of this study was to investigate the effect of immediate and delayed activation of two different self etching primer adhesives [One Up Bond-F and AdheSE] on bond strength to enamel. Sixty freshly extracted human maxillary premolars were used in this study. The enamel of the buccal surfaces of the teeth were ground flat to create a 2-mm flat buccal enamel surfaces. After creation of the flat enamel surfaces, the teeth were divided equally into six groups [10 each]. In groups. 1 and 4. The sell etching primer adhesives were applied passively undisturbed. In groups, 2 and 5, the sell etching primer adhesives were applied with immediate active application. While in groups 3 and 6, the self etching primer adhesives were applied with delayed activation. After 48 hours the teeth were subjected to shear bond strength testing. The results of this study showed that, immediate and delayed activation reduced significantly the bond strength of One Up Bond-F to enamel. On other hand, although immediate and delayed activation reduced the bond strength of AdheSE to enamel, the results were not of statistical significance. The bond strength of the two steps self etching primer adhesive was more superior then the one step sell etching primer adhesive. Strict Manufacturer instruct ions should be followed to achieve optimum bond strength result

Restoration of severely mutilated primary anterior teeth

One of the most prominent sequelae of severe form of early childhood caries is the mutilation of primary anterior teeth. Restoration of these teeth presents a challenge to the pediatric dentist. Restoration of these teeth usually involves pulpectomy followed by restoration of the coronal portion of the tooth by composite restoration. Different treatment modalities were tested in this study to compare the shear bond strength of such modalities. Sixty bovine primary anterior teeth were used in this study divided into six equal groups. These groups were classified according to the preparation and restoration following the loot canal treatment into Composite core group [gp I]. Composite with undercut [gp II], wire with undercut [pg III]. wire group [gp IV], polycarbonate post [gp V], fiber post [gp VI]. Groups were subjected to shear strength test by beam compression technique. Results showed that statistically there was no significant difference between different groups but the wire with undercut [gp III] showed the highest mean shear bond strength values, and gave a high percentage difference when compared with other groups, this was followed by composite with undercut group [81.83%], wire group [74.33%], composite core group [65.92%], polycarbonate post [61.35%], and lastly fiber post group [59.62%]