Bone density and implant stability with advanced platelet-rich fibrin in immediately loaded- implant assisted mandibular overdentures / Densidade óssea e estabilidade dos implantes com fibrina rica em plaquetas avançada em overdentures mandibulares com carga imediata

ABSTRACT Objective: The aim of this study is to determine the effect of Advanced Platelet-Rich Fibrin on bone density and implant stability in immediately loaded- implant-assisted mandibular overdentures (Split-mouth study). Material and Methods: Ten completely edentulous patients received two implants in the mandibular canine region and locator attachments were used to retain immediately loaded- implant mandibular overdentures. Each patient served in two Groups, one Group for each side. One side of the mandible received an implant with topical application of Advanced Platelet-Rich Fibrin in the implant osteotomy site (Group I) and the other site received an implant without application of Advanced platelet-rich fibrin (Group II). Each patient was examined clinically for implant stability using Osstell Mentor device and radiographically by ultra-low dose CT scan to measure bone density around the implant at baseline, three, six months, and one year. Results: There were no statistically significant differences (P>.05) in bone density and implant stability among the studied Groups during one year follow-up period. Conclusion : Advanced Platelet-Rich Fibrin has no effect on bone density and implant stability in immediately loaded implant-assisted mandibular overdenture.(AU)

RESUMO Objetivo: O objetivo deste estudo é determinar o efeito da Fibrina Rica em Plaquetas Avançada na densidade óssea e estabilidade dos implantes em Overdentures mandibulares com carga imediata (estudo de boca dividida). Material e Métodos: Dez pacientes edêntulos foram submetidos à instalação de dois implantes mandibulares na região dos caninos e pilares locator foram utilizados como sistema de retenção para as overdentures mandibulares com carga imediata. Cada paciente participou nos dois grupos, sendo um grupo para cada lado. Um lado da mandíbula recebeu implante com aplicação tópica de Fibrina Rica em Plaquetas Avançada no local do sítio cirúrgico do implante (Grupo I) e o outro local recebeu implante sem aplicação de Fibrina Rica em Plaquetas Avançada (Grupo II). Cada paciente foi examinado clinicamente quanto à estabilidade do implante usando o dispositivo Osstell Mentor e radiograficamente por tomografia computadorizada de ultrabaixa dose para medir a densidade óssea ao redor do implante no início do estudo, três, seis meses e um ano. Resultados: Não houve diferenças estatisticamente significativas (P>0,05) na densidade óssea e na estabilidade do implante entre os grupos estudados durante o período de acompanhamento de um ano. Conclusão: A Fibrina Rica em Plaquetas Avançada não tem efeito na densidade óssea e na estabilidade de implantes em Overdentures mandibulares com carga imediata (AU)

Epistaxis in a Pediatric Outpatient Clinic: Could It be an Alarming Sign?

Abstract Introduction Epistaxis is a common presentation among children. Objective To investigate the suitability of a simple tool of assessment for patients with epistaxis that could guide in subgrouping those with possible bleeding tendencies who may need further assessment. Methods Children who presented to a tertiary outpatient clinic with epistaxis of an unknown cause were recruited. They underwent thorough clinical assessment and answered the pediatric bleeding questionnaire and the epistaxis severity score. All patients underwent complete blood count as well as coagulation profile, and confirmatory diagnostic tests were performed as needed. Results Among the 30,043 patients who presented to the outpatient clinic over a year, 100 children had epistaxis, with an estimated annual frequency of 1 in 300. A total of 84% of the patients were younger than 12, and nearly half of these were younger than 6 years. Seventy-six patients had recurrent epistaxis, and 12 had systemic comorbidities. A significant higher percentage of patients presented with epistaxis in the hot months of the year. A total of 90% of the patients presented anterior bleeding, and the majority were treated with nasal compression only. Forty-three patients presented with epistaxis only; 37 of them were diagnosed as idiopathic epistaxis, and 6 had local causes. Fifty-seven patients presented with other bleeding manifestations, 47 of whom had a definite bleeding disorder and the other 10 had undiagnosed bleeding tendency. Those with other bleeding manifestations showed a higher frequency of positive family history of epistaxis; of being referred from a primary care physician; of having alarming low platelet count, and of presenting less seasonal variability. A bleeding score ≥ 2 showed significant value in suspecting an underlying systemic pathology as a cause of epistaxis. Conclusion The pediatric bleeding questionnaire is a useful and simple tool in the identification of pediatric patients who need further diagnostic testing to detect any underlying bleeding tendency.

Influence of diode laser and warm air drying on the shear bond strength of Lithium di-silicate to Dentin. An in-vitro study / Influência do laser de diodo e da secagem com ar quente na resistência ao cisalhamento do Di-silicato de Lítio a dentina. Um estudo in-vitro

Objective: The current study aimed to evaluate the effect of diode laser irradiation (980 nm) and warm air drying (50°C) on shear bond strength between Lithium di-silicate (IPS e.max; Ivoclar) and human dentin using both (Etch & Rinse) adhesive, Adper™ Single Bond 2 (3M ESPE) and (Self-etch) adhesive, Single Bond UniversalTM(3M ESPE) before adhesive polymerization. Material and Methods: 54 sound lower molars were sectioned to obtain flat dentinal surfaces. Specimens were divided into 2 equal groups (n=27): Group 1 (ER) and Group 2 (SE) according to bonding approach. Each subgroup was subdivided according to dentin surface treatment into 3 equal subgroups (n=9): Control (Co), Diode laser irradiation (L) and Warm air drying (W). All specimens were adhesively cemented to IPS e.max® CAD discs using RelyX™ Ultimate Clicker™(3M ESPE) resin cement. Samples were then subjected to pre-loading in a thermodynamic manner. All samples were tested for shear bond strength using computer-controlled material testing machine. Data analysis was performed using two-way (ANOVA) (p< 0.05) followed by pair-wise Tukey's post-hoc tests. Results: In (SE) group, the subgroup (W) had the highest shear bond strength values followed by (Co) subgroup and the least was (L) subgroup with statistically significant difference. As for (ER) group, the subgroup (W) had the highest shear bond strength values followed by (Co) subgroup and the least was (L) subgroup with no statistically significant difference. Conclusion: Warm air drying for (SE) bonding approach increased shear bond strength of Lithium di-silicate to human dentin and can be introduced as a new effective protocol.(AU)

Objetivo: o objetivo do estudo atual é avaliar o efeito da radiação do laser de diodo (980nm) e secagem de ar quente (50°C) na resistência ao cisalhamento entre dissilicati de Lítio (IPS e.max; Ivoclar) e a dentina humana usando ambos modelos de adesivos (condicionamento total) Adper™ Single Bond e (auto-condicionante) Single Bond Universal™ (3M ESPE), Single Bond UniversalTM (3M ESPE) antes da fotopolimerização. Material e Métodos: 54 segundos molares inferiores foram selecionados para obter superfícies dentinárias planas. Os espécimes foram divididos em 2 grupos iguais (n=27): grupo 1 (ER) e grupo 2 (SE) de acordo com protocolo de adesividade. Cada grupo foi subdividido de acordo com o tratamento de superfície dentro de 3 subgrupos iguais (n=9): Controle (co), irradiação com laser de diodo (L) e secagem com ar quente (W). Todos os espécimes foram adesivamente cimentados a discos de IPS emax CAD usando RelyX Ultimate Clicker (3M ESPE) cimento resinoso. As amostras foram então submetidas a pré-carregamento de forma termodinâmica. Todas as amostras foram testadas para resistência a cisalhamento usando máquina de teste de materiais controlados por computador. A análise de dados foi realizada usando ANOVA dois fatores (p<0.05) seguindo por testes de Tukey pareado como test post-hoc. Resultados: No grupo (SE), o subgrupo (W) apresentou maiores valores de resistência ao cisalhamento seguindo o subgrupo (Co) é o menor foi o subgrupo (L) com diferença estatisticamente significativa. Já para o grupo (Er), o subgrupo (W) apresentou os maiores valores de resistência ao cisalhamento seguido do grupo (Co) e o menor foi o subgrupo (L) sem diferença estatisticamente significante. Conclusão: a secagem com ar quente para a abordagem de adesividade (Se) aumentou a resistência ao cisalhamento do dissilicato de lítio à dentina humana e poderia ser introduzido como um novo e eficaz protocolo(AU)

Ulcerative colitis with concomitant primary sclerosing cholangitis

@#Primary sclerosing cholangitis (PSC) is the most common liver disease and known hepatobiliary complication of ulcerative colitis (UC). Concomitant PSC in UC is associated with increased risk of rapid progression of primary sclerosing cholangitis, and malignancy including colon carcinoma as well as hepatobiliary carcinoma. We report a case of a 26-year-old woman who was diagnosed as ulcerative colitis during her second pregnancy. Her liver function test showed a significant elevation of alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT) with other parameters being within normal range. A clinical suspicion of primary sclerosing cholangitis was then made. Magnetic resonance cholangiopancreticography (MRCP) revealed beaded appearance of the right and left intrahepatic ducts with focal narrowing seen at the ducts, suggestive of primary sclerosing cholangitis. She was subsequently started on oral Ursodeoxycholic acid (UDCA) with improvement in her liver function test within 3 weeks of initiation of treatment.

An epidemiological study of syphilis and predictors of treatment failure in University Malaya Medical Center

@#Introduction: There are limited studies on the epidemiology of syphilis in Malaysia. In this study we describe the clinical features and treatment outcomes of patients with syphilis attending a tertiary referral university hospital. Methods: We retrospectively reviewed the case records of patients with positive serology findings for syphilis in University Malaya Medical Center (UMMC) from January 2010 to December 2015. Serological positivity was defined as having a positive rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) with a confirmatory positive Treponema pallidum particle agglutination assay (TPPA). Treatment outcomes were divided into two, success or failure. Demographic and clinical characteristics associated with predictors of treatment failure were assessed using statistical package for the social science (SPSS). This study also included a neurosyphilis descriptive sub-study. Results: There were 637 patients identified with positive syphilis serology, but 258 patients were excluded as they did not meet the inclusion criteria. 379 patients were then taken for the demographic study; 14 patients (3.7%) were treated for neurosyphilis; 170 patients with complete data were included. In all 42/170 (24.7%) failed treatment, 12/170 (7.1%) had reinfection and 116/170 (68.2%) had treatment success. A final number of 158 patients were then taken and analyzed for predictors of treatment failure after excluding the 12 reinfection patients. Only low baseline RPR (<1:16) was found to be significant on multivariate logistic regression analysis (p value: 0.007, 95% CI: 1.42, 9.21). Conclusion: Most of the patients were HIV positive and from the MSM (Men who have sex with Men) population. Low baseline RPR titre is a predictor of treatment failure.

Cryptosporidiosis in immuno compromised children

Background: Cryptosporidium parvum is an obligate intracellular parasite of the Coccidia class that infects the microvilli epithelial cells of the digestive and respiratory systems

Objectives: this study aims to detection of the prevalence of cryptosporidiosis among immune compromised children who receive chemotherapy and to compare the three different methods for diagnosis of Cryptosporidium

Methodology: 200 children in Aswan oncology institute were enrolled in this study, clinical assessment as well as stool examination by modified Ziehl-Neelsen stain, ELISA assay and Immunofluorescence tests were done

Results: The study showed that the over-all infection was 43.5% by immunofluorescence method, 40.5% by ELISA and 28% by modified Ziehl-Neelsen stain. Infection rate increases in haematological malignancies [AML54.8%, HD46.2 %, ALL41.6%, NON HD 27.3%] than non haematological malignancy [wilms 50%, sarcoma 45.5%, and neuroblastoma 42.9%]

Conclusion: Cryptosporidium infection is an important public health problem in Immunocompromised children, raising awareness about cryptosporidiosis has very important effect to decrease prevalence of this parasitic infection

Assessment of left ventricular diastolic function in nonalcoholic fatty liver disease

Background: Nonalcoholic fatty liver disease [NAFLD] is a spectrum of fat-associated liver conditions that can result in end stage liver disease. NAFLD patients when compared to control subjects have a higher prevalence of atherosclerosis which is independent of obesity and other established risk factors. Recent studies have identified NAFLD as a risk factor for early subclinical abnormalities in myocardial metabolism as well as in cardiac structure and function. In particular, it has been shown that NAFLD is associated with left ventricular hypertrophy and impaired diastolic function

The Objective: The aim of this study is to assess left ventricular diastolic function in NAFLD patients

Patients and Methods: The study included thirty Egyptian NAFLD patients their age between 20 and 45 years old, and twenty healthy control subjects who were age and sex matched. Full medical history, complete physical examination and laboratory tests were done in form of ALT, AST, total cholesterol, LDL, HDL, triglyceride, hemoglobin A1C, creatinine, urea and CBC. Abdominal ultrasonography and transthoracic echocardiography also were done

Results: NAFLD patients had higher diastolic blood pressures, increased body mass indices, ALT, AST and glycated hemoglobin A1C more than controls. Also in our study the mean of E, E/A ratio, DT, lateral E/e and septal E/e is significant higher in NAFLD patients than control group. The mean of lateral e and septal e is lower in NAFLD patients than control group

Conclusion: Patients with NAFLD had significant impairment on diastolic function in the non-diabetic and normotensive NAFLD patients compared to the controls as measured by two-dimensional echocardiography Doppler imaging in addition to tissue Doppler imaging

[Prevalence of erectile dysfunction in patients consulting urological clinics: multi-centric survey in the Algerian west]

Aim: The aim of this study was to make an inventory of the prevalence, the severity, the reasons for the patient's consultation and the therapeutic measures indicated by urologists for erectile dysfunction [ED] in the west of Algeria

Methods: This survey was conducted among 4 urologists. All male patients, aged over 18 years, presenting to clinics during the study period of 2 months were included. Data collection was based on a self-administered questionnaire on socio-demographic data, comorbidities especially urological and sexual health history. The evaluation of ED was achieved by the single question of John B. McKinlay. One more question was asked to evaluate trouble reported by the patient's partner

Results: This survey included 185 patients. It showed a high prevalence of ED [59.5%], correlated with age. The mean age was 61 +/- 13 years. Thirty four percent of patients had severe ED. The reason for consultation was dominated by prostatic diseases [70%], the ED accounted for only 9% of the reasons for consultation. Only 26% of patients reported having talked previously to a doctor about their ED. These disturbances were "unacceptable" for 25% of patients and "moderately acceptable" for 30%. A minority of patients [16%] was treated medically for their ED [half of them received PDE5 inhibitors alone or in combination]

Conclusion: This first survey in the urological Algerian community emphasizes the importance of sexual dysfunction in patients consulting in urology. Although the prevalence of ED is important, few patients consult specifically for this reason. As a result, treatment is limited. Better physician awareness of the problem of ED is recommended

Radiofrequency catheter ablation of premature ventricular beats among Egyptians: predictors of success and recurrence

Background: Premature ventricular beats [PVBs] are early depolarization of the myocardium originating in the ventricle, the prognosis in patients with frequent PVBs and no obvious organic heart disease is usually very good. However, many patients are severely symptomatic with impaired quality of life

Aim of the study: We aimed at our study to assess the success of radiofrequency catheter ablation of monomorphic PVB and its impact on improvement of left ventricular [LV] systolic functions

Patients and Methods: The current study was conducted on 40 patients with frequent symptomatic monomorphic PVBs, candidate for PVB radiofrequency catheter ablation in cardiology department, Ain Shams University, between 2013 and 2015. All patients were subjected to thorough history taking, complete general and local examination, conventional 2D echocardiography and pre-procedural Holter ECG monitoring. Patients were divided to two groups [20 patients in each group] according to the presence or absence of structural heart disease. Electrophysiological mapping and ablation was done for all patients, and their clinical, electrophysiological and procedural aspects were analyzed. Follow up echocardiography and Holter ECG monitoring was done 3-6 months later to assess recurrence and impact on LV internal dimensions and systolic functions

Results: Acute success was achieved in 35 patients [87.5%], and long term success was achieved in 30 patients [75%], with elimination of PVBs and distressing symptoms among group of patients with procedural success. Presence of structural heart disease was not related statistically to procedural failure or long term recurrence. Magnitude of reduction of PVB burden had significant correlation with improvement of systolic functions [P=0.04]. Significant improvement of echocardiographic parameters was witnessed among group with baseline LV systolic dysfunction

Conclusions: Radiofrequency catheter ablation is an effective and safe therapeutic tool for frequent monomorphic PVBs and should be addressed as 1[st] line option for reversal of PVB induced LV systolic dysfunction

A Rare Case of Monostotic Spinal Fibrous Dysplasia Mimicking Solitary Metastatic Lesion of Thyroid Carcinoma

Monostotic fibrous dysplasia of the vertebra is a rare entity. A case of a 53-year-old lady who presented with an 8 months history of pain in the thoracic spine region with paraparesis is discussed. She had a history of papillary thyroid carcinoma and had undergone total thyroidectomy one year prior to her current problem. Magnetic resonance imaging revealed isolated osteolytic lesion over the posterior element of the T12 vertebra with narrowing of the spinal canal causing compression of the cord. The diagnosis of fibrous dysplasia was made histologically. Fibrous dysplasia rarely occurs in axial bones compared with peripheral bones. This case illustrates that osteolytic lesion of the vertebrae should be evaluated with detailed radiological and histopathological examination before an empirical diagnosis of spinal metastasis is made in an adult with a background history of primary malignancy well-known to spread to the bone.

Blood glucose level after febrile convulsion / 소아과

No abstract available.

Blood glucose level after febrile convulsion / 소아과

No abstract available.

Immunohistochemical studies in mice liver immunized by attenuated Schistosoma Mansoni Schistosomules by gamma radiation

Background: Schistosomiasis is an important cause of hepatic fibrosis in man. As etiological therapy alone is not enough to treat hepatic fibrosis, finding other strategies that can control the disease is important. Considering the dominant role of vaccination, research on gamma radiation- attenuated vaccine has become a new focus and has very promising value

Aim of the work: The objective of this study was to detect the effect of vaccination with attenuating dose of gamma radiation of schistosomules in controlling immunohistochemical changes in mice model of human schistosomiasis mansoni

Materials and methods: Forty mice were divided into four groups [ten each]. Group A served as normal control, group B was infected by subcutaneous [S. C.] injection with 100 S. mansoni cercariae/mouse [infected control], group C was vaccinated by [S.C.] injection with 500 schistosomulae irradiated with 20 Krad gamma- radiation [vaccine control] and group D was vaccinated by [S.C.] injection with the same dose of irradiated schistosomules and then challenged after 4 weeks by S.C. injection with 100 S. mansoni cercariae. Expression of alpha-smooth muscle actin [alphaSMA], desmin, collagen type-1 and transforming growth factor-beta1 [TGF-beta1] in the extracellular matrix [ECM] using immunohistochemistry were done

Results: exhibited in infected control group B marked expression of alpha-SMA, desmin, collagen type-1 and TGF-beta1. These changes were moderate in vaccinated-control group C while few changes were detected in vaccinated-challenged group D

Conclusion: It was concluded that using 20 Krad-gamma irradiated schistosomules as vaccine is effective in controlling liver pathology and reduces immunohistochemical changes

Optimization of coronary sinus lead position in cardiac resynchronization therapy guided by three dimensional Echocardiography

Background: Cardiac resynchronization therapy [CRT] is now an established effective treatment for patients with advanced heart failure. One approach to improve CRT outcome may be determination of the degree of dsynchrony before CRT as a predictor for CRT response. Conversely, the focus may be on an improved positioning of CRT left ventricular [LV] lead

Aim of the study: We aimed at our study to define the rule of three-dimensional echocardiography in determining the optimal site of LV pacing lead

Patients and Methods: The current study was conducted on 30 patients with heart failure who had received CRT in Ain Shams University Hospitals in the period from 2012 to 2014. All patients were subjected to thorough history taking, complete general and local examination, conventional 2D echo and 3D echo analysis. The latest wall to reach the minimal volume was determined. The patients were classified after CRT insertion into group A with concordance between the delayed LV area and LV lead position and group B with discordance between them. Our patients were followed up for 6 months duration

Results: Our findings demonstrated that the response to CRT resulted in improvement of NYHA class [p-value 0.04], LV EF by 2D and 3D echocardiography [P value <0.001 for both] with significant increase in LV 3D SV [p value 0.001], and significant reduction of LA diameter [p-value 0.03], LVESD diameter, 2D and 2D LVESV [P value 0.026, 0.026 respectively], however there was no any statistically significant difference between both groups

Conclusions: No additional benefit of selecting LV lead position pre CRT insertion to be concordant with the latest myocardial segment in reaching the minimal systolic volume assessed by 3D echocardiography

Rare Locations of Schwannomas: A Few Comments

No abstract available.

Nine-Month Follow-up Results of Treatment for Nasolacrimal Duct Obstruction by Probing with Adjunctive Mitomycin C in Adults: A Prospective Randomized Placebo-Controlled Trial / 전남의대학술지

The current study aimed to determine the efficacy of probing with adjunctive mitomycin C (MMC) as a treatment for nasolacrimal duct obstruction (NLDO) in adults and to study the association of probing success with demographic and obstruction characteristics. This was a prospective, randomized, double-blind, placebo-controlled trial including 140 patients (each with a unilateral NLDO) scheduled for nasolacrimal probing who were randomly assigned to receive MMC (0.2 mg/ml, 70 patients; group A) or placebo (normal saline, 70 patients; group B). Irrigation was carried out with 0.5 cc of MMC (0.2 mg/mL) in the duct with a nasal pack for 10 minutes in group A. Patients' postprobing epiphora was evaluated at 2 weeks and 1, 3, 6, and 9 months postoperatively. Probing was judged to be a success if there was no or mild watering for at least 9 months after the procedure. There were no significant differences between the two study groups in demographic characteristics or duration of the operation (p=0.062). The overall success rate of probing with MMC was 47/70 (67.1%), which was significantly higher than the success rate of the procedure with placebo (p=0.0027). When the sex of the patients was controlled for by logistic regression, a significant association between the failure rate of probing and increasing age was found in cases and controls (p=0.004 vs. p=0.006, respectively). No significant side effects of probing with MMC were noted after 9 months of follow-up. Administering MMC in a dosage of 0.2 mg/mL during nasolacrimal probing significantly increased the success rate of probing. The failure rate of probing increased with age. A low dose of MMC is cheap, safe, and easily accessible; thus, it is recommended during nasolacrimal probing, especially in patients who refuse dacryocystorhinostomy surgery.

Combined Use of Intrathecal Opioids and Dexmedetomidine in the Management of Neuropathic Pain

No abstract available.

An Update on the Management of Diabetic Neuropathic Pain: A Few Comments

No abstract available.

Dehydroepiandrosterone Sulfate as a Risk Factor for Premature Myocardial Infarction: A Comparative Study / 가정의학회지

BACKGROUND: This study aimed to evaluate some of the major risk factors of myocardial infarction including dehydroepiandrosterone sulfate in patients with premature myocardial infarction (age or =50 years). METHODS: This is a parallel case-control study on 50 premature myocardial infarction patients and 50 myocardial infarction patients. We also recruited 50 matched participants for each of the two groups. Patients and their control groups were assessed for dehydroepiandrosterone sulfate serum level, diabetes mellitus, hyperlipidemia, hypertriglyceridemia, and hypertension. In addition, family history of cardiovascular disease and current smoking was recorded. Univariate and multivariate logistic regression analyses were performed to evaluate predictors of premature myocardial infarction and myocardial infarction. RESULTS: No significant differences were observed between the demographic data of patients and their controls. The dehydroepiandrosterone sulfate serum level was significantly higher in patients with premature myocardial infarction compared with controls. Multivariate logistic regression analysis revealed only serum dehydroepiandrosterone sulfate dehydroepiandrosterone sulfate level to be significantly associated with premature myocardial infarction (odds ratio, 2.65; 95% confidence interval, 1.44 to 4.877; P = 0.002). Additionally, hypertension was found to be associated with myocardial infarction. CONCLUSION: Higher levels of serum dehydroepiandrosterone sulfate level are associated with premature myocardial infarction but not with myocardial infarction, and this association is independent of the effects of other risk factors.

Safety of Epidural Steroid Injection Methods in the Management of Recurrent Lumbar Disc Herniation: Few Comments

No abstract available.