Resin Nano-Ceramic Material Surface Roughness, Color Stability, and Bacterial Adhesion Evaluation After Different Scaling Methods / Rugosidade superficial, estabilidade de cor e adesão bacteriana de resina nano-cerâmica após diferentes métodos de raspagem

Objective: TThe study evaluated in vitro the changes in roughness, color stability, and bacterial count of a CAD/CAM Resin Nano-Ceramic material surface treated by various scaling procedures. Material and Methods: 70 disks (5mm diameter, 0.5 mm thickness) of Resin Nano-Ceramic (Lava ™Ultimate, 3M, ESPE) material were cemented in standardized cavities prepared in bovine teeth. A custom-made scaling apparatus of a double pan balance was used for different scaling methods, simulating standard clinical conditions. The specimens were assigned to three main groups: no scaling(C), ultrasonic scaling (U), and manual scaling (M). Each group was then divided into three subgroups according to scaling tip material; stainless steel tip (St), plastic tip (P), and titanium tip (Ti). The surface texture was analyzed quantitatively and qualitatively with a tactile profilometer and atomic force microscopy. A spectrophotometer was used for color measurement. Streptococcus mutans were counted in a colony counter. All the data were tabulated and statistically analyzed. Results: Two-way ANOVA was used to study the effect while One-way ANOVA was performed to compare between study groups. The significance level was set at p ≤ 0.05. The ultrasonic titanium tip(UTi) revealed the significant highest mean value of alterations (p < 0.001). The integrity of the material surface was altered in the form of deep scratches on the ultrasonically scaled surfaces and numerous smaller scratches on the hand-scaled surfaces. Conclusion: The plastic instrument would appear to be the instrument of choice during a routine maintenance procedure for Resin Nano-Ceramic materials (AU).

Objetivo: Este estudo avaliou in vitro as alterações na rugosidade, estabilidade de cor e quantidade de bactérias da superfície de uma resina nano-cerâmica produzida em CAD/CAM tratada por diferentes procedimentos de raspagem. Material e Métodos: 70 discos (5 mm diâmetro, 0,5 espessura) de resina nano-cerâmica (Lava ™Ultimate, 3M, ESPE) foram cimentadas em cavidades padronizadas preparadas em dentes bovinos. Um aparato customizado de raspagem com pratos duplos de balança foram usados para os diferentes métodos de raspagem, simulando uma condição clínica padronizada. Os espécimes foram distribuídos em três principais grupos: Sem raspagem (C), raspagem ultrassônica (U) e raspagem manual (M). Cada grupo foi dividido em três subgrupos de acordo com a ponta do material de raspagem; ponta de aço inoxidável (St), ponta plástica (P), ponta de titânio (Ti). A textura da superfície foi analisada qualitativamente e quantitativamente por um perfilômetro tátil e microscopia de força atômica. Um espectrofotometro foi usado para a mensuração da cor. Estreptococos mutans foram contados em um contador de colônias. Todos os dados foram tabulados e analisados estatisticamente. Resultados: Anova dois fatores foi utilizado para estudar os efeitos, enquanto ANOVA um fator foi utilizado para comparar os grupos experimentais. O nível de significância foi estabelecido em p≤ 0,05. A ponta de ultrassom de titânio (UTi) revelou o valor significante mais alto de alterações (p < 0,001). A integridade da superfície d matérias foi alterada na forma ranhuras profundas, nas superfícies raspada por ultrassom e numerosas ranhuras menores nas superfícies raspadas à mão. Conclusão: O instrumento plástico poderia apresentar-se como um instrumento de escolha durante o pocedimento de manutenção routineira para materiais de resina nano-ceramica. (AU)

Transepithelial Laser versus Alcohol Assisted Photorefractive Keratectomy Safety and Efficacy: 1-Year Follow-up of a Contralateral Eye Study

Purpose@#To compare single-step transepithelial photorefractive keratectomy (TPRK) to conventional alcohol assisted epithelial removal then photorefractive keratectomy (AAPRK) regarding pain, epithelial healing, visual acuity, corneal haze measured subjectively and objectively, higher order aberrations changes, contrast sensitivity and vector analysis of astigmatic correction with one year follow-up. @*Methods@#A prospective double-blind randomized study of 29 subjects (58 eyes) who underwent myopic aberration-free laser correction by smart pulse technology using Schwind Amaris 1050 Hz with 1-year follow-up. Right eye was randomly treated by AAPRK or TPRK. Postoperative assessment was performed on day 1 and 3, at 1st week, and 1st, 3rd, 6th, and 12th months. Patients were assessed for pain, epithelial healing, visual acuity, corneal haze, astigmatic correction, higher order aberrations and contrast sensitivity. @*Results@#Epithelial healing was complete by the 3rd day in 62.1% of AAPRK eyes and in 89.7% of TPRK eyes. First day postoperative pain was higher in TPRK group (p = 0.0134). The decimal uncorrected visual acuity at 12 months was 1.47 ± 0.39 and 1.57 ± 0.38 in the AAPRK and TPRK groups respectively (p = 0.3719). Post-photorefractive keratectomy haze reached a final level of 0.04 ± 0.14 and 0.02 ± 0.1 in AAPRK and TPRK groups respectively (p = 0.5607). Contrast sensitivity was comparable in low and high frequency cycles per degree. Vector analysis of astigmatic correction showed correction index at one year of 0.99 and 1.05 for AAPRK and TPRK groups respectively. @*Conclusions@#Alcohol assisted and transepithelial photorefractive keratectomy have comparable results regarding safety and efficacy.

Transepithelial Laser versus Alcohol Assisted Photorefractive Keratectomy Safety and Efficacy: 1-Year Follow-up of a Contralateral Eye Study

Purpose@#To compare single-step transepithelial photorefractive keratectomy (TPRK) to conventional alcohol assisted epithelial removal then photorefractive keratectomy (AAPRK) regarding pain, epithelial healing, visual acuity, corneal haze measured subjectively and objectively, higher order aberrations changes, contrast sensitivity and vector analysis of astigmatic correction with one year follow-up. @*Methods@#A prospective double-blind randomized study of 29 subjects (58 eyes) who underwent myopic aberration-free laser correction by smart pulse technology using Schwind Amaris 1050 Hz with 1-year follow-up. Right eye was randomly treated by AAPRK or TPRK. Postoperative assessment was performed on day 1 and 3, at 1st week, and 1st, 3rd, 6th, and 12th months. Patients were assessed for pain, epithelial healing, visual acuity, corneal haze, astigmatic correction, higher order aberrations and contrast sensitivity. @*Results@#Epithelial healing was complete by the 3rd day in 62.1% of AAPRK eyes and in 89.7% of TPRK eyes. First day postoperative pain was higher in TPRK group (p = 0.0134). The decimal uncorrected visual acuity at 12 months was 1.47 ± 0.39 and 1.57 ± 0.38 in the AAPRK and TPRK groups respectively (p = 0.3719). Post-photorefractive keratectomy haze reached a final level of 0.04 ± 0.14 and 0.02 ± 0.1 in AAPRK and TPRK groups respectively (p = 0.5607). Contrast sensitivity was comparable in low and high frequency cycles per degree. Vector analysis of astigmatic correction showed correction index at one year of 0.99 and 1.05 for AAPRK and TPRK groups respectively. @*Conclusions@#Alcohol assisted and transepithelial photorefractive keratectomy have comparable results regarding safety and efficacy.

Oxidant-antioxidant status in Egyptian children with sickle cell anemia: a single center based study / Estado oxidante-antioxidante em crianças egípcias com anemia falciforme: estudo baseado em um único centro

OBJECTIVE: the present study was conducted to investigate the oxidant-antioxidant status in Egyptian children with sickle cell anemia. METHODS: the serum levels of total antioxidant capacity (TAO), paraoxonase (PON), vitamin E, nitrite, and malondialdehyde (MDA) were measured in 40 steady state children with homozygous sickle cell anemia (24 males and 16 females) and 20 apparently healthy age- and gender-matched controls. RESULTS: mean serum TAO, PON, vitamin E, and nitrite levels were significantly lower in the group with sickle cell anemia, whereas mean serum MDA was significantly higher in these children compared to controls. No significant differences in mean levels of TAO, PON, nitrite, vitamin E, and MDA were found in sickle cell anemia patients receiving hydroxyurea when compared with those not receiving hydroxyurea. A significant negative correlation between serum nitrite and the occurrence of vaso-occlusive crises (VOC) was observed (r = -0.3, p = 0.04). PON level was found to be positively correlated with patients' weight and BMI (r = -0.4, p = 0.01; r = -0.7, p < 0.001, respectively), but not with frequency of VOC. The area under the curve of serum nitrite in predicting occurrence of VOC was 0.782, versus 0.701 for PON, and 0.650 for TAO (p = 0.006). Serum MDA was not correlated with nitrite, PON, TAO, or vitamin E levels. No significant correlations were detected between serum nitrite and hemoglobin or antioxidant enzymes. CONCLUSION: children with sickle cell anemia have chronic oxidative stress that may result in increased VOC, and decreased serum nitrite may be associated with increases in VOC frequency. A novel finding in this study is the decrease in PON level in these patients, which is an interesting subject for further research. .

OBJETIVO: o presente estudo foi realizado com o objetivo de investigar o estado oxidante-antioxidante em crianc¸as egípcias com anemia falciforme. MÉTODOS: dosamos os níveis séricos da capacidade antioxidante total (CAT), paraoxonase (PON), vitamina E, nitrito e malondialdeído (MDA) em 40 crianças estáveis com anemia falciforme homozigótica (24 meninos e 16 meninas), e 20 controles pareados por idade/sexo aparente-mente saudáveis. RESULTADOS: os níveis séricos médios da CAT, PON, vitamina E e nitrito foram significativamente menores, ao passo que o nível sérico médio de MDA foi significativamente maior em crianças com anemia falciforme (AF), em comparação aos controles. Não foram encontradasdiferenças significativas nos níveis médios de CAT, PON, nitrito, vitamina E e MDA em pacientescom AF em tratamento com hidroxiureia, em comparação aos que receberam hidroxiureia. Encontramos uma correlação negativa significativa entre o nitrito sérico e a ocorrência decrises vaso-oclusivas agudas (CVO) (r = -0,3, p = 0,04). Descobrimos que o nível de PON está correlacionado positivamente com o peso e o IMC dos pacientes (r = -0,4; p = 0,01; r = -0,7; p < 0,001, respectivamente), porém não com a frequência de CVO. A área sob a curva (ASC) donitrito sérico na previsão da ocorrência de CVO foi 0,782, em comparação a 0,701 para PON e 0,650 para CAT (p = 0,006). O MDA não está correlacionado a nitrito, PON, CAT ou vitamina E. Não foram detectadas correlações significativas entre nitrito sérico e hemoglobina ou enzimas antioxidantes. CONCLUSÃO: crianças com AF apresentam estresse oxidativo crônico que pode resultar emaumento das CVO. Em crianças com AF, a redução nos níveis de ...

Novel GLRB gene mutation in a Saudi baby with hyperekplexia.

Aim: We aim to describe a case of hyperekplexia in a Saudi neonate due to Novel mutation in GLRB. Case Presentation: One month old Saudi neonate with hypertonicity, repetitive episodes of jitteriness and exaggerated startle reflex. Discussion: Hyperekplexia (OMIM:149400, 138492 & 604159) is considered a rare, autosomal dominant neurological disorder that presents early in life with hypertonicity, exaggerated startle response and life threatening neonatal apnea. It has been caused by mutation in the alpha-1subunit (GLRA1) on chromosome 5q32, Beta subunit (GLRB) gene on chromosome 4q31 of the inhibitory glycine receptor and GLYT2 gene (SLC6A5) on chromosome 11p15 which encodes a presynaptic glycine transporter. Conclusion: Raising awareness of the presence of this treatable disease may prevent unnecessary exposure to anti-epileptic medications, prevent life threatening apneas and improve long term outcome.

Avoiding mastoid cavity problems: mastoid obliteration using bioactive glass

The aim of this study was to evaluate bioactive glass as an ideal material for the purpose of mastoid cavity elimination after mastoid surgery to avoid mastoid cavity problems. In 20 patients diagnosed as cholesteatoma or chronic unsafe ear, we used different surgical techniques according to pathology and situation during surgical exploration, basically adhering to standard principles of eradicating disease in chronic unsafe ear. After performing the canal wall down [CWD] or the canal wall up [CWU] technique, mastoidectomy was followed by obliteration of mastoid cavity by particulate form Bioglass. Cases were divided according to operative procedures, type of reconstruction and material used into 3 groups A- Canal wall up mastoidectomy followed by obliteration of mastoid cavity by particulate form Bioglass. B- Canal wall down mastoidectomy followed by reconstruction of posterior meatal wall and obliteration of mastoid cavity by particulate form Bioglass. C- Canal wall down mastoidectomy followed by reconstruction of posterior meatal wall by conchal cartilage and obliteration of mastoid cavity by Bioglass. Bioactiveglass paste is very effective for mastoid obliteration in the three groups with good integration to the surrounding tissues either connective tissue, bone, meninges or lateral dural sinus without any adverse reaction on the dura even with contact to Bioglass. Infection was seen in 2 cases [10%], however was readily controlled by topical application of antibiotics daily for one week. In both cases no extrusion of the material occurred. The successful formation of bone with elimination of mastoid cavity problems proved that using Bioglass is appropriate for performing clinical mastoid obliteration

Impact of mono or combined interferon therapy on thyroid function in chronic hepatitis C virus adult patients

Egypt has the highest prevalence of antibodies to hepatitis C virus [HCV] in the world, estimated nationally at 14.7%. Numerous HCV prevalence studies in Egypt have published various estimates from different Egyptian communities, suggesting that Egypt, relative to the other nations of the world, might be experiencing intense ongoing HCV transmission. Interferon-alpha [IFN-alpha] monotherapy or combined therapy with ribavirin is the cornerstone therapeutic agent for chronic HCV infection. Treatment with IFN may cause thyroid dysfunction. Unfortunately, the clinical approach to this toxic effect is often carried out by personal judgment rather than by defined guidelines. Indeed, clinicians often reduce the dose or sometimes discontinue IFN-alpha treatment in those patients who develop thyroid dysfunction. This may reduce the therapeutic response to this drug. Hence, this study was undertaken to evaluate the impact of INF-alpha monotherapy or combined therapy with ribavirin on thyroid function in chronic HCV adult patients of both sexes in the period from January 2009 to August 2009. Sixty adult chronic HCV patients with normal thyroid function before the start of treatment with IFN-alpha - or IFN-alpha + ribavirin were selected for the study. Of them, 7 patients discontinued treatment, 1 patient died and 5 patients could not be followed during the study period. So the number of patients enrolled in the study after 6 months was 47. Clinical examination for thyroid dysfunction as well as thyroid function tests was then carried out. The study revealed that 17 patients [36.1%] developed abnormal thyroid dysfunction. This risk increased with female gender and in combined therapy with ribavirin. The incidence of hypothyroidism was more than hyperthyroidism particularly, in patients treated with combined therapy. Given the high prevalence of HCV disease in Egypt, it is essential that physicians treating patients with IFN-alpha be aware of the clinical spectrum of thyroid dysfunction, and test for thyroid function prior to starting IFN therapy. Careful thyroid surveillance throughout the treatment period is mandatory, especially in female patients and in those receiving combined therapy with ribavirin. Moreover, patients should be informed of this risk and should be advised to tell their physicians of any related symptoms

Pegylated interferon with ribavirin in the treatment of chronic active hepatitis C in Egyptian patients: efficacy of response in a retrospective study

Chronic hepatitis C is one of the major causes of cirrhosis, hepatocellular carcinoma and considered the main indication for liver transplantation. In Egypt, high HCV rates were reported among several population groups reaching up to 20%. Interferon Alfa is the current therapy forchronic hepatitis C .Yet, combination therapy of Alfa interferon and ribavirin is more effective than interferon alone in increasing the response rates. Aim of work is to study efficacy of response in Egyptian patients with chronic active hepatitis C who had received pegylated interferon plus ribavirin as regarding the biochemical and virologic response. The results of this study showed that patients received Pegylated interferon alfa-2a plus ribavirin had significant improvement in serum ALT levels in around 71% of them. Also 58.94%of these patients achieved sustained clearance of the virus six months after stopping treatment. The combination therapy of Pegylated interferon alfa and ribavirin is effective in achieving biochemical and virological responses and is highly recommended as an initial therapy for patients with chronic hepatitis C

Tuberculosis of the shoulder: an unusual presentation

There is a recent increase in the incidence of musculoskeletal tuberculosis, especially among the homeless, the immigrant population, the immunocompromised and also due to emerging multidrug-resistant strains of Mycobacterium tuberculosis. Osteoarticular tuberculosis poses a diagnostic dilemma to the clinician. Advanced disease closely mimics other granulomatous diseases, infections and even malignancy. Unfortunately, delayed diagnosis of tuberculous infection in the extra-axial skeleton leads to progressive joint deformity and destruction. Radiological imaging while not being specific, can map the extent of the disease to arrive at the earliest possible diagnosis. In this report, we present the unusual radiological findings of tuberculous infection of the shoulder

effect of meassel water-pipe smoking versus cigarette smoking on pulmonary arterial pressure and left ventricular and right ventricular function indices in COPD patients, an echodoppler study

This study included 165 COPD heavy smoker patients with a mean age of 59.9 +/- 8.9 year referred for echo Doppler and cardiac assessment. They were divided according to their type of smoked material into three groups; cigarette smoker group, meassel water-pipe smoker group and cigarette and water-pipe smoker group. The aim of the study was to assess the prevalence of echo Doppler abnormalities in those patients looking for any specific pattern induced by meassel. The results have shown that the common effects of the whole smoker groups when compared to the non-smoker group were as follows: Severe reduction in FEV 1/FVC%, arterial pO2 reduction, left ventricular diastolic dysfunction, right ventricular diastolic dysfunction, impaired index of global right ventricular function, decreased pulmonary acceleration time and right ventricular enlargement. However, water-pipe smoker group if compared to cigarette smoker group showed more aggressive pulmonary obstruction, more degree of pulmonary hypertension, more right ventricular enlargement and more deterioration of right ventricular global function index. In conclusion, the hazards of heavy water-pipe meassel smoking on echo Doppler, FEV1/FVC% and arterial blood gases indices are not only similar to those of heavy cigarette smoking but also it cause more respiratory obstruction, more pulmonary hypertension and more deleterious effect on right ventricular size and global function

Study of interleukin-6 and interleukin-8 in Egyptian patients with chronic liver disease due to hepatitis C and bilharziasis

In this study, the serum levels of previous cytokines IL-6 and IL-8 were measured in 60 patients and 20 controls by ELISA technique. The patients were classified into group A [20] cases with type C-CAH, group B [20] cases with mixed pathology type C-CAH and bilharziasis which was subdivided into group B1 [ten cases with active bilharziasis] and group B2 [ten cases with inactive bilharziasis] and group C [20 cases with hepatic cirrhosis which was subdivided into group C1 and group C2]. The results have shown that there was a statistical difference of serum levels of IL-8 in group B1 in comparison with group B2, while there was a change in IL-6 in group B1 in comparison with group B2. Also, there was a statistical difference of serum level of IL-6 and IL-8 in group C1 in comparison with group C2. It was concluded that viral specific activated T-cell response occurred in type C- CAH with or without bilharziasis with subsequent release and elevation of proinflammatory and protective cytokines such as IL-6 and IL-8. Also, this increase of previous cytokines was related to the degree of HCV activity

Effects of oxytocin and dextrose 5% infusion during labor on neonatal serum sodium, glucose and bilirubin levels

Maternal serum sodium and glucose levels were measured in three groups of laboring women before and after labor. Cord serum samples were also analyzed for the same parameters as well as for bilirubin, and after 72 hours of labor, a neonatal serum sample was analyzed again for bilirubin. The study groups included cases who had full term vaginal delivery and who had no medical or obstetric complication The first group [group A] had neither fluid, nor oxytocin administration during labor. The second group [group B] received 5% glucose in water during labor. The third group [group C] received Oxytocin in 5% glucose infusion [1 unit in 100 ml]. All groups were comparable as regards maternal age, parity and gestational age. Newborns were comparable as regards birth weight and Apgar score, and weight of placenta. Maternal serum sodium [Na] and glucose did not show any significant correlation with cord serum values. Cord serum Na and glucose did not show significant correlation with the 72 hours neonatal serum bilirubin values. A significant increase in neonatal serum bilirubin was found in both groups B and C after 72 hours of birth. On the other hand, mean serum bilirubin [72 hours level] was higher in oxytocin group than in the control group and in the glucose only group. We concluded that the dose range used in this study [less than one litre - IV aqueous glucose solution given during labor] does not induce significant changes in either maternal or cord serum values of Na and glucose. Also oxytocin could be considered responsible of neonatal hyper bilirubinemia without inducing neonatal hyponatremia

histogenesis of mucoepidermoid carcinoma: histological and ultrastructural study

Seven cases of mucoepidermoid carcinoma of minor salivary gl and s, located in the palate [five cases] and lip [two cases] were encountered in the present study. By light microscopy, three cell types [mucous, squamoid and intermediate] were observed. Ultrastructural examination of four of these cases was used to reveal the type of cellular differentiation. Mainly, biphasic patterns were detected [luminal and myoepithelial cells with varying degrees of differentiation]. Based on the present findings and its correlation with histogenetic aspect, acinar intercalated duct region can be stressed as an origin for the development of mucoepidermoid carcinoma in as much as most of salivary gl and tumors originate

presence of melanocytes in the lining epithelium of maxillary sinus mucosa

Dendritic cells containing melanin pigment have been demonstrated with silver impregnation in the epithelial lining of the maxillary sinus in seven cases. An extensive review of literature has shown that melanocytes are found in some unusual locations, but previous finding of their existence in the epithelial lining of the maxillary sinus has not been reported. The literature is reviewed, and the pathologic significance of this observation in relation to the histogenesis of melanomas of the paranasal sinuses with special emphasis to the maxillary sinus is discussed

Melanoacanthomatous hyperplasia of the oral cavity: histological and histochemical study

Melanoacanthomatous hyperplasia of the oral cavity is a rare reactive phenomenon analogous histologically to the skin melanoacanthoma. A few cases were previously reported in the literature under the name "oral melanoacanthoma". This study comprised the largest series and the first to be found in Asians. Fourteen cases were detected among 27 unclassified melanotic lesions, in which a definite history of trauma was documented in five cases. Histologically, bicellular proliferative reaction of dendritic melanocytes and squamous cell proliferation, which along with evidence of inflammation in the underlying lamina propria may characterize the lesion as a part of a spectrum of reactive process rather than neoplasia

Combined odontogenic tumour: calcifying epithelial odontogenic tumour and odontoma

Two examples of calcifying epithelial odontogenic tumor, which contained areasdiagnostic for odontoma, were presented. The histologic presentation wasdiscussed with a special emphasis on the fact that these two separateodontogenic tumors have not been reported previously as occurringsimultaneously in one lesion

Histiocytosis-x disease: histopathology and histochemical study

Eight cases of histocytosis X disease [H and-Schuller-Christian disease]; 2 cases-Eosinophilic granuloma; 2 cases-Letterer-Siwe disease; 4 cases] with oral lesions were studied histologically and histochemically. Histochemical evaluation of mucopolysaccharides was undertaken by application of PAS stain in an effort to establish, if any, histochemical criteria for microscopic differentation .The main proliferating cells were different in every tumor type; many eosinophils in eosinophilic granuloma, numerous histiocytes with foam cells in Hand-Schuller-Christian disease, large number of undifferentiated reticuloendothelial cells in Letterer-Siwe disease. The histochemical investigations revealed that strong PAS positive material could be observed in eosinophilic granuloma, while the other two forms showed faint reaction. Large number of cases are required to confirm such differences. Interestingly, dental tissue changes were observed in Letterer-Siwe disease; it comprised an increase in the width of secondary dentin and the interglobular dentin, hydropic degeneration of odontoblasts of the dental pulp. Since oral lesions might be the first manifestation of the disease, histologic differentiation betwewn these forms is considered to be an important factor in the diagnosis because of the extreme variability of prognosis and management

Bone response to zinc and non-zinc silver amalgam implants

Freshly mixed, unset zinc free and zinc containing amalgam were implanted in the right and left tibias of twelve Sparque-Dowley rats. Specimens were examined under light microscope. Animals were sacrifised after one, two, four and six weeks period. Acute inflammatory reaction was observed after one week in zinc containing implant while it was mild in non-zinc amalgam implants. This inflammatory reactions gradually reduced by time until disappeared after four weeks as the zinc cautions were released from one to thirty days