Effects of Combined Visible and Infrared Light Rhinophototherapy in Patients With Allergic Rhinitis.

BACKGROUND: Intranasal phototherapy offers an alternative treatment method for patients with allergic rhinitis who cannot benefit from intranasal corticosteroids and oral antihistamines. Different wavelengths have been tried with promising results. OBJECTIVE: In this present study, we aimed to investigate the effects of visible light-infrared light phototherapy on clinical improvements together with its cytologic effects in patients with allergic rhinitis. METHODS: Patients with confirmed allergic rhinitis were given a 4-week course of intranasal phototherapy treatment. Weekly symptom questionnaires were applied to monitor clinical effects. Nasal lavage specimens were obtained before the start and at the completion of the 4-week therapy. Fluorescence-activated cell sorting analyses of CD16+, CD24+, and CD 45+ cells were performed. Statistical analyses are performed of weekly changes in symptoms and cell counts. RESULTS: CD45+CD16highCD24+ neutrophil count in nasal lavages decreased significantly whereas CD45+CD16dim/-CD24+ eosinophil counts significantly increased and CD45+ granulocyte counts remained unchanged. Symptom scores including nasal itching, nasal discharge, nasal obstruction, sneezing, eye itching, throat itching, and ear itching all statistically decreased compared to baseline at the end of 4 weeks. CONCLUSION: Four-week course of intranasal phototherapy with visible and infrared light leads to clinical improvement in allergic rhinitis patients.

Radiographic and clinical outcomes of distal tibia fractures (3-12 cm proximal to the plafond): Comparison of two intramedullary nailing.

BACKGROUND: There are various distal locking options for the repair of tibia distal diametaphyseal fractures with intramedullary nails. There is no consensus about the superiority of any of these distal locking options. In our study, comparing nails with distal bolt locking screw (DSBLS) and conventional nails; we aimed to compare the clinical and radiological results of intramedullary nail models in fixing tibial distal diametaphyseal fractures. METHODS: In our orthopedics and traumatology department, 117 tibial distal diametaphyseal fractures of 116 patients treated with intramedullary nails between August 2007 and May 2015 were retrospectively evaluated. Forty-six tibial distal diametaphyseal fractures of 45 patients who came to regular visits to outpatient clinic controls and who had a minimum follow-up of 18 months and whose fracture distance was between 3 and 12 cm were included in the study. The average follow-up period of the study group consisting of 28 males and 17 females with an average age of 44 (16-76 years) which was 48 months (18-100 months). The group using the DSBLS locking intramedullary nail was considered the first group and the group using the conventional distal locking intramedullary nail was considered the second group. Radiological union times, coronal, sagittal, and axial plan angulations and malunion presence were com-pared between the two groups. In addition, the two groups were compared clinically with length of time spent on weight-bearing and return to work, Olerud-Molander ankle score, and American Orthopedic Foot and Ankle Society Score scores. RESULTS: We found that the first group was superior in terms of length of time spent on partial and full weight-bearing between the two groups (p=0.00031 and p=0.00007). In addition, the union time of the first group was shorter (p=0.0149). Other radiological or clinical results did not differ significantly between the two groups. In addition, no significant correlation was found between the distance of the fracture from the tibial plate and its angulation. In cases with malunion alone, the fracture line was more distal than those without malunion (p=0.0411). CONCLUSION: Newly developed DSBLS intramedullary nails give as good results as conventional nails in tibia distal diametaphyseal fractures. Due to its ability to loading bone early and have a shorter union time, DSBLS can be safely preferred in distal diametaphyseal fractures and reduce complications from immobilization.

Bupivacaine vs. lidocaine: a comparison of local anesthetic efficacy in impacted third molar surgery.

OBJECTIVES: The aim of this study was to compare the anesthetic efficacy, the duration of anesthesia, and the postoperative analgesia of lidocaine and bupivacaine and to determine any difference in hemodynamic parameters in patients who required impacted third molar removal. MATERIALS AND METHODS: Thirty-eight patients between the ages of 18 and 40, with no systemic disease, were included in the study, with an indication of impacted lower third molar extraction. One of two local anesthetic agents (Marcaine and Jetokain Simplex) was randomly selected for tooth extractions. The parameters evaluated were the onset of anesthetic agent action, the duration of operation, the duration of postoperative analgesia, and postoperative visual analog scale scores. Hemodynamic parameters were observed and evaluated preoperatively and during the operation. All data were evaluated statistically. RESULTS: When the time of anesthesia onset was analyzed according to both anesthetic solutions, the difference was in favor of lidocaine (p = 0.01). The duration of action was longer in the bupivacaine group than in the lidocaine group (p = 0.00002). VAS values for the pain obtained during injection were lower in the lidocaine group (p = 0.009).However, according to the results of our study, the postoperative analgesic efficacy of bupivacaine is similar to that of lidocaine (p = 0.087). CONCLUSION: After evaluation of these results, we can recommend the use of lidocaine and bupivacaine safely in dentistry practice. But long-duration effect of bupivacaine and the rapid effect of lidocaine may make lidocaine more preferable. CLINICAL RELEVANCE: It is important to determine the clinically effective and safe anesthetic solution.

The effects of hyperinsulinemia on cochlear functions.

CONTEXT: Hyperinsulinemia is the most common metabolic change associated with cochleovestibular diseases. AIM: We aimed to investigate the auditory functions in hyperinsulinemic individuals. SETTINGS AND DESIGN: A total of 164 patients were included in this case-control study. While 76 patients with insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR] of ≥2.5) constituted the case group, 88 patients with HOMA-IR values of <2.5 constituted the control group of the study. MATERIAL AND METHODS: The 75 g oral glucose tolerance test, blood biochemistry tests, hormonal analysis, audiological assessment, electrocochleography (EcochG), and transient evoked otoacoustic emissions (TEOAE) testing were performed. STATISTICAL ANALYSIS: One-way analysis of variance and Kruskal-Wallis analysis of variance were used for the comparison of the metabolic and ear parameters in the normal glucose tolerance (NGT), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) groups. The chi-square test was used to compare nominal variables. Spearman and Pearson correlation coefficients were used for the correlation analyses of continuous variables. RESULTS: The pure tone audiometry at 0.5, 1, 2, and 4 kHz was better in the case group than in the control group. A positive correlation was found between HbA1c and right ear 0.5, 1, 4, and 8 kHz threshold values and left ear 2, 4, 6, and 8 kHz threshold values. A negative correlation was found between HbA1c and speech discrimination scores. The right ear 1.00 and 2.83 kHz TEOAE measurements in the individuals with NGT were found higher than those in patients with IGT, and the 1.42 kHz TEOAE measurements and reproducibility were found higher than those in patients with IFG. The left ear 1.00 and 1.42 kHz TEOAE measurements of the IGT patients were found lower than those of IFG and NGT patients. CONCLUSION: We showed that hearing was worsening in hyperinsulinemic patients and prediabetic conditions were related to hearing function impairment.

Prospective randomized single-blind study of post-operative bleeding after minor oral surgery in patients with cirrhosis.

BACKGROUND/AIMS: The management of patients with cirrhosis requiring dental extractions is complicated due to an increased risk of post-operative bleeding. Topical hemostatic agents are usually required to control bleeding in these cases, as an adjunct to systemic measures of hemostasis. The aims of this randomized, prospective, single-blind clinical study are twofold. The primary aim is to compare the hemostatic efficacy of chitosan and surgicel in patients with cirrhosis after a tooth extraction, and the secondary aim is to assess the value of the current setting as a clinical model of post-operative bleeding following minor oral surgery. MATERIAL AND METHODS: Fifty patients with cirrhosis scheduled for a tooth extraction under local anesthesia were prospectively included in the study in a randomized fashion. Patients were blinded to the treatment group they were in. The cirrhosis classification, bleeding time, trauma score, and corrected bleeding time (during post-operative reviews) were recorded. Statistical evaluations were done. RESULTS: Study groups had an equal number of teeth extractions (40 teeth each). There were no statistically significant differences between the groups with respect to patient demographics, cirrhosis classification, trauma score, and bleeding time. No side effects were noted. CONCLUSION: Both Celox and Surgicel are effective for controlling bleeding and are safe after a tooth extraction in patients with cirrhosis.

A stepped approach for the management of symptomatic internal derangement of the temporomandibular joint.

BACKGROUND: Internal derangement is the clinical and pathological condition of disc displacement of the temporomandibular joint. Management of these cases involve conservative and surgical treatment options. Minimally invasive surgical procedures namely arthrocentesis and arthroscopy are promising techniques in the management of internal derangement. However patient selection algorithms, indications for minimally invasive procedures and details of the techniques should be further studied for safe and cost effective management of these cases. This manuscript aims to retrospectively analyze the significance of a stepped surgical treatment approach (arthrocentesis under local anaesthesia as the first line of treatment, followed by arthroscopic lysis and lavage under general anaesthesia in unresolving cases) of internal derangement with or without osteoarthritis. METHODS: This is a retrospective cohort study. Case notes of 1414 patients that were managed with a standard protocol were reviewed. Appropriate inclusion and exclusion criteria were set. Thirty-three patients were eligible for inclusion. Parameters recorded were pain-free inter-incisal opening, spontaneous pain, pain on function, difficulty on chewing, and perceived disability on jaw movements. Pre-operative and post-operative (at the end of the follow up period) pain free maximum interincisal opening values were compared with paired t test and the subjective parameters were evaluated with Chisquare analysis. Treatment outcome and success rate according to American Association of Oral and Maxillofacial Surgeons were descriptively shown. RESULTS: Interincisal opening values increased, and the number of patients with severe or medium rated subjective parameters were reduced at discharge. These improvements were found to be statistically significant. Clinical (Wilkes) staging of internal derangement pre-operatively and at discharge remained either unchanged or was lower. Treatment outcome and success according to American Association of Oral and Maxillofacial Surgeons criteria was 94%. CONCLUSION: The stepped approach for the management of symptomatic internal derangement with or without osteoarthritis is a successful treatment strategy with favourable therapeutic outcomes.

The effect of teeth in mandibular fracture lines.

BACKGROUND/AIM: The decision to retain or extract teeth in the line of mandibular fractures has been a subject of debate in the scientific literature, and there is a need for further evidence to clear this issue. Thus, the aim of this study was to investigate the effects on healing of teeth in the line of mandibular fractures in order to contribute to the field. MATERIAL AND METHODS: The case notes of 100 patients with teeth in the line of 106 mandibular fractures were reviewed. Open reduction and rigid internal fixation (ORIF) was used if elastic intermaxillary reduction failed to achieve a satisfactory occlusion and/or anatomical reduction in the fragments as assessed by orthopantomogram (OPG) and clinical examination. The remaining cases had maxillomandibular fixation (MMF) with an arch bar and bridle wire. RESULTS: Three of the 106 teeth involved in the fracture lines healed with complications. In the cases where the teeth had been removed prior to fracture treatment, or in cases of delayed extractions, no complications were noted. CONCLUSION: The factors which should be considered for removal include the condition of the teeth and alveolar bone, the timing and the type of treatment. This decision should be made on an individual basis considering potential risks to avoid complications.

Conversion of coal-fired bottom ash to fuel and construction materials.

In this study, solid wastes taken from Seyitomer coal-fired power plant bottom ashes were subjected to experimental research to obtain a carbon-rich fraction. The possible recycling opportunities of remaining inorganic fraction in the cement and concrete industry was also investigated. Flotation technique was used to separate unburned carbon from inorganic bottom ashes. Collector type, collector, dispersant and frother amounts, and pulp density are the most important variables in the flotation technique. A number of flotation collectors were tested in the experiments including new era flotation reactives. Optimum collector, dispersant and frother dosages as well as optimum pulp density were also determined. After experimental work, an inorganic fraction was obtained, which included 5.41% unburned carbon with 81.56% weight yield. These properties meets the industrial specifications for the cement and concrete industry. The carbon content of the concentrate fraction, obtained in the same experiment, was enhanced to 49.82%. This fraction accounts for 18.44% of the total amount and can be mixed to the power plant fuel. Therefore total amount of the solid waste can possibly be recycled according to experimental results.

Lidocaine versus mepivacaine in sedated pediatric dental patients: randomized, prospective clinical study.

UNLABELLED: Dental anxiety is usually seen in the pediatric patients. specially in the case of minor oral surgical procedures and exodontia, cooperation of the patients and their families with the dentist will lead to superior treatment outcomes. Pain control is important in dentistry. The aim of this randomized prospective clinical study is to compare the local anaesthetic and haemodynamic effects of 2% lidocaine (Group 1) and 3% mepivacaine (Group 2) in sedated pediatric patients undergoing primary tooth extraction. STUDY DESIGN: 60 pediatric patients undergoing sedation for elective primary tooth extraction was prospectively included in the study in a randomized fashion. Inclusion and exclusion criteria were assigned. Patients were given premedication via oral route. Local anesthesia was achieved before extraction(s). RESULTS: There were no significant differences between the groups in patient demographics, number of teeth extracted, duration of the operation and time from the end of the procedure to discharge (p ≥ 0.05). FLACC pain scale scores were not statistically significant between the groups, except at 20 minutes post-operatively when the score is significantly lower in Group 2 (p=0.029). CONCLUSION: Prevention of pain during dental procedures can nurture the relationship of the patient and dentist. Tooth extraction under sedation in pediatric patients could be safe with both local anesthetics.

Delayed replantation of an avulsed tooth after 5 hours of storage in saliva: a case report.

This article reports a clinical case of a 8-year-old boy, who underwent an avulsion of the upper left central incisor. The avulsed tooth was kept in the oral cavity in direct contact with saliva for 5 h from the moment of trauma until its replantation. Treatment guidelines for avulsed mature permanent teeth were followed. The clinical and radiographic findings after 2 years revealed absence of root resorption, ankylosis or mobility of the replanted tooth.

Recycling of coal combustion wastes.

The separation of unburned carbon from coal-fired power plant bottom ashes was conducted in order to increase the possibility of the recycling of coal combustion wastes. A two-stage flotation technique was used for this study. In the rougher flotation experiments the amounts of collector, dispersant and frother, pulp density, pH, particle size distribution, flotation time and flotation temperature were tested as variables. After rougher flotation experiments, at optimum conditions, the carbon content of the concentrate increased from 13.85 to 51.54% at a carbon recovery of 54.54%. Under the same conditions, the carbon content was reduced to 4.54% at a weight yield of over 80% in the tailings fraction. This fraction meets the industrial specifications and can be utilized as a cement additive. After the cleaner flotation experiment the carbon content of the product was enhanced to 64.81% with a 52.16% carbon recovery. This fraction can be blended back into the coal feed to the power plant boilers.

Outcome of dentigerous cysts treated with marsupialization.

OBJECTIVE: The aim of this study was to evaluate the results of dentigerous cysts in children treated with marsupialization. STUDY DESIGN: 35 dentigerous cysts from 35 children treated with marsupialization were included in the study. The age of the children ranged from 8 to 13 years old. RESULTS: The findings of our study showed that the outcome of dentigerous cysts treated with marsupialization is successful resulting with the eruption of teeth and regeneration of bone. Accordingly a successful outcome was achieved either with or without the help of an orthodontic treatment. Postoperative follow-ups were un-eventful in all patients during a 5 year period. CONCLUSION: The results of the present study demonstrate that marsupialization may be a better choice of treatment for dentigerous cysts in children rather than the standard treatment.

Epidermoid cyst in the floor of the mouth: report of a case.

The occurrence of epidermoid cysts in the oral cavity is extremely rare. These cysts generally present slow and progressive growth and often are not diagnosed until the second or third decade of life. Epidermoid and dermoid cysts in the floor of the mouth are painless, doughy or fluctuant lesions and cause no symptoms until they are large enough to interfere with speech or eating. This article presents the case of a 20-year-old man with swelling in the floor of his mouth that was causing difficulties with speech and swallowing. After surgical removal of the cyst, histopathologic examination confirmed the diagnosis of epidermoid cyst. Characteristics of epidermoid cysts are described and surgical treatment discussed.

Bacteremia incidence in pediatric patients under dental general anesthesia.

BACKGROUND: The aim of this study was to assess the incidence of bacteremia from various procedures in children undergoing dental treatment under general anesthesia. METHODS: Three blood samples for cultures were obtained from each patient; the first sample (10 ml basal) at the onset of the process and the second sample (10 ml) within 30 seconds following the nasotracheal intubation. The third blood sample (10 ml) was taken 30 seconds after the extraction of a deciduous tooth or a permanent tooth or slow drilling. Following incubation in an automated blood culture system, bacteria were identified by using conventional biochemical methods and commercial identification systems. Chi-square test was used to assess the findings statistically. RESULTS: All blood cultures were negative before intubation (baseline) in every patient. However, the percentage of positive samples in deciduous tooth extraction and permanent tooth extraction groups were 18/26 (69.2%) and 18/25 (72%), respectively. These values were significantly greater than the results of baseline 0/74 (0%), slow drilling 3/23 (13%), and nasotracheal intubation 9/74 (12.3%) (P < .05). CONCLUSION: Consequently, the patients treated under dental general anesthesia have to be evaluated with detailed physical examination and antibiotic prophylaxis should be given if required in order to prevent further unexpected bacterial endocarditis.

Beneficiation of graphite fines from moulding factory wastes.

As the costs of waste disposal increase, more attention is being placed upon the re-use and recycling of valuable minerals contained within the waste streams. In this article, the waste streams from a moulding factory were treated by physical methods to obtain a re-usable graphite fraction. Multi-gravity separators (MGS) and shaking tables (ST) are being used in coal processing and heavy minerals beneficiation. In the present study, the possibility of using an MGS and ST to separate graphite from moulding sand was analysed as part of such investigations. The effects of changes in different process variables on the concentrate sand content and graphite recovery values were studied. Several parameters, thought to have an effect on the separation were tested. After the ST experiments, a graphite concentrate was obtained having 4.5% sand content with 60.8% recovery. After the investigations carried out by MGS, a graphite concentrate was obtained having 0.95% sand content with 68.0% recovery. The results demonstrated that recovered graphite fractions can be re-used in the factory, thus reducing the quantity of waste and costs.