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Table of Contents
January 2018
Volume 21 | Issue 1
Page Nos. 1-118
Online since Tuesday, February 6, 2018
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ORIGINAL ARTICLES
Evaluation of fractioned nitric oxide in chronic cough patients
p. 1
Y Yildiz, M Igde
DOI
:10.4103/1119-3077.224785
PMID
:29411715
Introduction:
Cough exceeding 3-8 weeks was defined as chronic cough in various guides. Asthma is the most common cause of chronic-specific cough. Causes other than asthma include prolonged bacterial bronchitis and upper airway cough syndrome (UACS). Nitric oxide (NO) causes vascular smooth muscle relaxation, bronchodilation, and oxidant effects via its metabolite, peroxynitrite. An increase in NO results in inflammation, vasodilatation, and bronchial edema.
Materials and Methods:
The study group included 90 patients aged 6-17 years selected from individuals presenting to the Pediatric Immunology and Allergic Diseases Clinic with cough persisting for 4 weeks and 30 other patients representing to the control group. Patients with a history of premature birth and long-term ventilatory support, neuromotor retardation, or chronic lung and heart disease received systemic corticosteroid therapy in the previous 4 weeks, a chest deformity, with any chronic disease or received immunotherapy were excluded from the study.
Results:
The most common diagnosis among the 90 patients in this study was asthma, observed in 27 (30%). Fractional exhaled NO values were highest in the asthma group at 39.5 ± 26.6 parts per billion (ppb) and lowest in the UACS group at 11.6 ± 4.0 ppb. Values in the control group were 17.8 ± 11.1 ppb. The differences between the groups were statistically significant (
P
< 0.001).
Conclusion:
Fractional exhaled NO measurement can be used as a quick and reliable diagnostic method in patients presenting with chronic cough due to its high positive predictive value, its practical nature, the fact that it is a noninvasive method and that it does not require the use of medication.
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Effect of color shading procedures and cyclic loading on the biaxial flexural strength of zirconia
p. 7
I Tuncel, I Turp, A Usumez
DOI
:10.4103/1119-3077.224789
PMID
:29411716
Purpose:
Zirconia is the most preferred ceramic restoration in posterior areas because of its flexural strength. The aim of the study is the evaluation of biaxial flexural strength of different colored zirconium oxide core materials after cyclic loading.
Material and Methods:
Zirconia discs (12 mm diameter and 1.2 mm thickness) were divided into 6 groups of 12 discs each. Groups were colored according to the Vita Classic shade guide: A3 and D4. One group was not colored and left as control. Each group was randomly divided into subgroups and subjected to mechanical cycling prior to biaxial flexural strength test. Cyclic loading was applied as 50 N loads for 20,000 times for the loaded groups. Samples were subjected to biaxial flexural strength test in a universal testing machine with a crosshead speed of 1 mm/min. Two-way analysis of variance (ANOVA) and Tukey's HSD tests were used for comparisons of the groups.
Results:
Biaxial flexural strength values did not vary significantly depending on coloring procedure or loading process tested (p>.05). XRD analysis displayed that the monoclinic volume fraction of zirconia was highest in cyclic loaded D4 and was lowest in non-loaded control group. The SEM image revealed that A3 color solution created metallic coloring pigments at grain boundaries.
Conclusions:
Coloring procedures and cyclic loading did not affect the biaxial flexural strength of zirconia core material; however, microstructural analysis displays changes, which may weaken the zirconia structure on the long term.
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Evaluation of two different rapid maxillary expansion surgical techniques and their effects on the malar complex based on 3d cone-beam computed tomography
p. 13
P Aktop, S Biren, S Aktop, M Motro, C Delilbasi, G Gurler, G Dergin
DOI
:10.4103/1119-3077.224794
PMID
:29411717
We compared and evaluated the effects of two techniques used for surgically assisted rapid maxillary expansion (SARME) using three-dimensional (3D) cone-beam computed tomography, focusing on changes in soft and hard tissue in the malar region. A conventional Le Fort I osteotomy group (10 patients, mean age: 19.3 years) and a high Le Fort I group (12 patients, mean age: 20.4 years) underwent 3D analyses. Changes in hard and soft tissue of the malar region were compared. The average increases in the bone malar width and soft malar width in the high Le Fort I group between the pre- and postoperative periods were 1.43 ± 1.23 and 1.39 ± 1.19 mm, respectively. The average increases in the bone malar depth on the right and left sides in the high Le Fort I group were 1.34 ± 0.81 and 1.60 ± 0.54 mm, respectively. Progress in hard tissues did not reflect significant changes in soft tissue.
Context:
Effects of high Le Fort I SARME on the malar complex.
Aims:
To compare and evaluate the effects of two techniques used for SARME, using 3D cone-beam computed tomography, focusing on changes in hard and soft tissues in the malar region.
Settings and Design:
A conventional Le Fort I osteotomy group (10 patients, mean age: 19.3 years) and a high Le Fort I group (12 patients, mean age: 20.4 years).
Methods and Material:
Each group underwent 3D analyses, and changes in hard and soft tissues of the malar region were compared.
Statistical Analysis Used:
The SPSS software (ver. 15.0 for Windows) was used. The Kolmogorov-Smirnov test, Student's
t
test, and paired-samples test were conducted.
Results:
The average increases in the bone malar width and soft malar width in the high Le Fort I group between the pre- and postoperative periods were 1.43 ± 1.23 and 1.39 ± 1.19 mm, respectively. The average increases in the bone malar depth on the right and left sides in the high Le Fort I group were 1.34 ± 0.81 and 1.60 ± 0.54 mm, respectively.
Conclusions:
Progress in hard tissues did not reflect significant changes in soft tissue.
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Glucose pump test can be used to measure blood flow rate of native arteriovenous fistula in chronic hemodialysis
p. 22
YC Yavuz, NY Selcuk, L Altıntepe, I Güney, S Yavuz
DOI
:10.4103/1119-3077.224790
PMID
:29411718
Purpose:
In chronic hemodialysis patients, the low flow of vascular access may leads to inadequate dialysis, increased rate of hospitalization, morbidity, and mortality. It was found that surveillance should be performed for native arteriovenous (AV) should not be performed for AV graft in various studies. However, surveillance was done in graft AV fistulas in most studies. Doppler ultrasonography (US) was suggested for surveillance of AV fistulas by the last vascular access guideline of National Kidney Foundation Disease Outcomes Quality Initiative (NKF KDOQI). The aim of study is to determine whether glucose pump test (GPT) is used for surveillance of native AV fistulas by using Doppler US as reference.
Methods:
In 93 chronic hemodialysis patients with native AV fistula, blood flow rates were measured by Doppler US and GPT. For GPT, glucose was infused to 16 mL/min by pump and was measured at basal before the infusion and 11 s after the start of the infusion by glucometer. Doppler US was done by an expert radiologist. Used statistical tests were Mann-Whitney
U
test, Friedman test, regression analysis, and multiple regression analysis.
Results:
Median values of blood flow rates measured by GPT (707 mL/min) and by Doppler US (700 mL/min) were not different (
Z
= 0.414,
P
= 0.678). Results of GPT and Doppler US measurements were positive correlate by regression analysis. The mean GPT value of diabetic patients (
n
= 39; 908 mL/min) was similar to that of nondiabetic patients (
n
= 54; 751 mL/min;
Z
= 1.31,
P
= 0.188). GPT values measured at three different dialysis session did not differ from each other that by Friedman test (
F
= 0.92,
P
= 0.39). This showed that GPT was stable and reliable.
Conclusions:
Glucose pump test can be used to measure blood flow rate of native AV fistula. GPT is an accurate and reliable test.
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Gender differences and demographics and type of cardiac device over a 10-year period
p. 27
M Aktoz, MF Uçar, MA Yılmaztepe, G Taylan, S Altay
DOI
:10.4103/1119-3077.224797
PMID
:29411719
Aims:
This study aims to review the influence of gender-specific differences and patient demographics on cardiac device and pacing mode selection over a 10-year period.
Methods
: We retrospectively reviewed patients who underwent first implantation of the cardiac device between January 1, 2006 and June 31, 2016.
Results:
During the study period, 704 patients underwent first cardiac device implantation. Number of patients undergoing pacemaker was 452 and number of patients undergoing implantable cardioverter defibrillator/cardiac resynchronization therapy and defibrillator (ICD/CRT-D) was 252. Patients undergoing pacemaker were 49.9% female with mean age 72.36+11.1. The most common indication was atrioventricular block (AVB) (84%) in both genders. The most frequently used pacing modes were VVI (70.8%), but over a 10-year period pacemaker selection shifted from VVI to DDD pacemakers. Patients undergoing ICD/CRT-D were 19.7% female with mean age 62.5+10.8. The most common indications for ICD/CRT-D was ischemic cardiomyopathy (ICMP) (55.0%). The rate of male patients was higher in patients who have received device therapy for dilated cardiomyopathy (DCMP) or ICMP, whereas the rate of female patients was higher in hypertrophic cardiomyopathy (HCMP) patients. The most common used implanted system was VVI-ICD (60.6%).
Conclusions:
The present study demonstrated that there was no significant difference between female and male patients in pacing mode selection, mostly VVI pacing mode was chosen; however, over a 10-year period pacemaker selection shifted from VVI to DDD pacemakers. Female patients had less ICD/CRT-D implantation than male patients.
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Evaluation of
Candida Albicans
biofilm formation on various parts of implant material surfaces
p. 33
C Gökmenoglu, NB Kara, M Beldüz, A Kamburoğlu, İ Tosun, E Sadik, C Kara
DOI
:10.4103/1119-3077.224793
PMID
:29411720
Aims:
Candida albicans
adhesion to any oral substrata is the first and essential stage in forming a pathogenic fungal biofilm. In general, yeast cells have remarkable potential to adhere to host surfaces, such as teeth or mucosa, and to artificial, non-biological surfaces, such as dental materials.
C. albicans
adhesion to denture materials is widely recognized as the main reason for the development of stomatitis. This study compared the susceptibility of different parts of the implant system with
C. albicans
adhesion.
Material and Methods:
Each material maintained contact with
C. albicans
suspension, and biofilm formations around the implant materials were evaluated. To evaluate the biofilm formation, the XTT technique and scanning electron microscopy (SEM) were used.
Results:
In general, a fine biofilm layer of
C. albicans
species was found on the surface of all examined materials. However, when examining the SEM images, candidal growth was significantly lower on the surfaces of the gingival former, abutment, and machined surface implant samples. According to the colorimetric assay (XTT), the gingival former samples revealed the lowest quantity of biofilms formed (median XTT value, 0.0891) (
P
< 0.001). The abutment and machined surface implant samples had low XTT values with similar values. The highest median colorimetric XTT values (0.1741), significantly higher than those of the other materials (
P
< 0.001), were for the bone level implant samples.
Conclusions:
This finding emphasizes implant treatment would be chosen complacency in patients who are prone to oral candidosis, medically compromised patients under immunosuppression, and patients with tumor who are being treated with chemotherapy or radiation.
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Effect of a galactagogue herbal tea on breast milk production and prolactin secretion by mothers of preterm babies
p. 38
E Özalkaya, Z Aslandoğdu, A Özkoral, S Topcuoğlu, G Karatekin
DOI
:10.4103/1119-3077.224788
PMID
:29411721
Background and Objectives:
Poor breast milk production is the most frequent cause of breastfeeding failure in preterm babies. The aim of our study is to evaluate the effect of herbal tea mixture containing stinging nettle (Natal, Hipp) on breast milk production and serum prolactin levels of mothers, and weight gain of preterm babies.
Materials and Methods:
We enrolled mothers and their babies who were less than 37 gestational week and less than 2000 g, fed with orogastric tube without any contraindication of enteral feeding in neonatal intensive care unit between November 2010 and June 2011. The mothers of treatment group (
n
= 32) were consuming commercially available herbal mixture tea for 1 week. The mothers control group (
n
= 21) received only the same advice on supportive measures as group I. Mothers in the placebo group (
n
= 32) were given fruit tea for 1 week. The daily breast milk production of mothers and weight gain of preterm babies were recorded. Also, serum prolactin levels of the mothers were measured.
Results:
Increase of the milk production from the first to the seventh day was more prominent in mothers using herbal tea mixture. Increased rate in the amount of milk was 80% in the treatment, 34.3% in the placebo and 30% in the control group (
P
= 0.000). There was no statistically significant difference in weight gain of babies between the two groups, due to formula feeding in case of insufficient breast milk. Serum prolactin levels of the mothers at the beginning and on the seventh day showed no significant difference.
Conclusions:
In mothers with premature babies and who are treated in neonatal intensive care unit, consumption of galactogogue herbal tea will increase lactation and prevent lack of human milk without any adverse effect.
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Gabapentin pretreatment for propofol and rocuronium injection pain: A randomized, double-blind, placebo-controlled study
p. 43
MY Çakirgöz, I Demirel, E Duran, AB Özer, UA Türkmen, A Ersoy, A Aksu, V Hancı
DOI
:10.4103/1119-3077.224791
PMID
:29411722
Aim
: This prospectively-planned, randomized, double-blind and placebo-controlled study aims to evaluate the effect of 1200 mg gabapentin premedication on the incidence and severity of propofol and rocuronium injection pain.
Method:
One hundred patients, between 18-60 years of age and ASA I-II for elective surgery planned under general anaesthetic, were randomized and divided into two groups. Two hours before the operation, the patients were given either a placebo tablet (Group P, n = 50) or 1200 mg gabapentin tablet (Group G, n = 50). On the back of the non-dominant hand, a vein was opened using a 20 G cannula , 0.9% NaCl was begun and preoxygenation was provided. For anaesthesia induction, 1% propofol at 800 ml/hr infusion rate was administered for 20 s. Propofol injection pain was evaluated up to the 20th second and recorded using a scale between 0 and 3 developed by McCrirrick and HunteR The remaining propofol dose (2.5 mg/kg), 5 ml saline and 0.6 mg/kg rocuronium were injected in that order over 10 seconds and rocuronium injection pain response was evaluated with a four point scale.
Results:
Pain after propofol infusion average score (degree ≥ 1) (Group G = 0.5; Group P = 1.0) and incidence (Group G = 46%; Group P = 68%); and average withdrawal movements response score linked to rocuronium injection pain (≥ 1 response) (Group G = 0.3; Group P = 1.2) and incidence (Group G = 20%; Group P = 80%) were detected to be significantly lower in the gabapentin group compared to the placebo group (
p
< 0.001).
Conclusion:
Premedication with 1200 mg gabapentin 2 hours before propofol and rocuronium injection reduced the incidence and severity of injection pain.
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Diagnostic role of neutrophil-lymphocyte ratio in oral cavity cancers
p. 49
M Düzlü, R Karamert, H Tutar, M Şahin, A Türkcan, M Yılmaz
DOI
:10.4103/1119-3077.224796
PMID
:29411723
Aim:
In this study, we aimed to evaluate the diagnostic role of neutrophil–lymphocyte ratio (NLR) and other hemogram parameters in differentiating nonmalignant oral cavity lesions from oral cavity cancers.
Methods:
Ninety-five patients who were performed oral cavity biopsy between the years 2013 and 2015 were retrospectively reviewed. The control group comprised consecutive 70 patients who underwent septoplasty/septorhinoplasty procedures. Inclusion criteria were to be available with common blood count (CBC) just prior to procedure. The hemogram parameters including NLR were compared between the groups.
Results:
Lymphocyte count and mean platelet volume (MPV) were found to be significantly decreased in oral cavity squamous cell carcinoma (SCC) and in other oral cavity cancers (OCCs) compared with benign oral cavity lesions and control group. In contrast, NLR revealed significantly higher in OCCs and in oral SCC compared with nonmalignant oral cavity lesions and control group. The receiver operating characteristics curve analysis suggested cutoff value of 2.88 for NLR in predicting malignancy [area under curve (AUC) 0.756, sensitivity 51%, specificity 88%].
Conclusions:
NLR was first shown to be significantly elevated in oral cavity cancers and in oral cavity SCC in this study. In our opinion, NLR may be helpful in identifying the oral cavity lesions at high risk for harboring malignancy.
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A Prospective, randomized study comparing 7-day and 14-day quadruple therapies as first-line treatments for helicobacter pylori infection in patients with functional dyspepsia
p. 54
A Yagbasan, D Ö Coşkun, Ö Özbakir, K Deniz, Ş Gürsoy, M Yücesoy
DOI
:10.4103/1119-3077.224784
PMID
:29411724
Objective:
Standard triple therapy for
Helicobacter pylori
has a low eradication rate in Turkey. The aim of this study was to evaluate and compare the effectiveness of 7-day and 14-day lansoprazole, amoxicillin, clarithromycin, and bismuth subsalicylate (LACB) treatment regimens as first-line
H. pylori
eradication therapies.
Materials and Methods:
This study included 70 patients with symptoms of dyspepsia and a positive
H. pylori
stool antigen test (SAT). Thirty-five patients received the modified quadruple therapy regimen for 7 days (LACB-7) whereas the remaining 35 patients received the treatment for 14 days (LACB-14). Eradication was assessed by SAT 1 month after the end of therapy.
Results:
A total of 64 patients completed the therapy. The cumulative per-protocol (PP) and intention-to-treat (ITT) eradication rates were 89% (
n
= 57/64) and 81.4% (
n
= 57/70), respectively. Both the PP and ITT eradication rates were superior in the LACB-14 group, compared with the LACB-7 group (PP: 90.6% vs. 87.5%; ITT: 81.4% vs. 80%, respectively), but these differences were not statistically significant (
P
= 0.689).
Conclusions:
Both the 7-day and 14-day first-line LACB therapies provided a high cure rate, were well tolerated, and were equally effective against
H. pylori
infection in Turkey.
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Vascular endothelial growth factor in pleural effusions and correlation with radiologic and biochemical parameters
p. 59
N Bayram, Y Karakan, M Uyar, B Ozyurt, A Filiz
DOI
:10.4103/njcp.njcp_370_16
PMID
:29411725
Introduction:
Pleural effusion is a common clinical problem with management difficulties. The aim of this study is to evaluate vascular endothelial growth factor (VEGF) in differential diagnosis of pleural effusions and the presence of correlation between radiological features and biochemical properties.
Materials and Methods:
The study included patients with pleural effusion. VEGF levels in the pleural fluid were measured by enzyme-linked immunosorbent assay.
Results:
A total of 97 patients who had exudative pleural effusion related to lung cancer (
n
= 17), nonpulmonary malignancies (
n
= 25), mesothelioma (
n
= 9), pneumonia (
n
= 14), tuberculosis (
n
= 8), miscellaneous causes (
n
= 6), and transudative effusion (
n
= 18) were included. Pleural VEGF levels were higher in exudative effusions with respect to transudative effusions (
P
< 0.001) and in effusions related to malignancies versus benign causes (
P
< 0.001). Pleural VEGF was inversely correlated with pleural fluid glucose and pH levels and had positive correlation with lactate dehydrogenase, protein levels (
P
< 0.001), hematocrit, and eosinophil values in the pleura (
P
< 0.05). Pleural VEGF levels were also higher in patients with massive effusions and pleural thickening (both
P
< 0.001).
Conclusions:
The overlap of pleural VEGF levels between the groups may limit the value of VEGF in discriminating between malignant versus benign and exudative versus transudative effusions; however, it may be a useful adjunct to various methods. The VEGF levels in pleural fluid seem to be related to the degree of inflammation and pleural invasion.
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Association between the oxidative status, Vitamin D levels and respiratory function in asthmatic children
p. 63
M Igde, P Baran, BG Oksuz, S Topcuoglu, G Karatekin
DOI
:10.4103/njcp.njcp_373_16
PMID
:29411726
Aim:
We studied the relationship between plasma concentrations of oxidative system markers, vitamin D, and respiratory functions in children with asthma.
Materials and Methods:
Ninety one children aged 6–17 years with stable asthma seen in the clinic had the serum concentrations of oxidative system markers [total antioxidant capacity (TAC), total oxidative status (TOS), paraoxonase-1 activity (PON-1), and 25-hydroxyvitamin D3] and respiratory functions were measured.
Results:
There was no statistical correlation between TAC and age and FEV1. There was a significant positive correlation between TAC and 25(OH)D3 (
r
= 0.214,
P
= 0.021), TAC and TOS (
r
= 0.218,
P
= 0.007), TAC and PON-1 (
r
= 0.230,
P
= 0.028), TAC and IgE (
r
= 0.194,
P
= 0.033), and inverse correlation between TAC and PEF (
r
= −0.208,
P
= 0.024). In the backward multiple regression analysis, 25(OH)D3 (
t
= 2.613,
P
= 0.011), age (
t
= −2.158,
P
= 0.034), TOS (
t
= 2.158,
P
= 0.000), and OSI index (
t
= −13.859
P
= 0.000) maintained an independent relationship with TAC (
r
= 0.858,
r2
= 0.737,
F
= 21.436,
P
= 0.000).
Conclusion:
Oxidative stress correlates with the serum vitamin D concentrations. Clinical trials are required to confirm that increasing serum 25OHD may improve asthma control, as measured by clinical and oxidative stress markers.
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Effect of titanium-prepared platelet-rich fibrin treatment on the angiogenic biomarkers in gingival crevicular fluid in infrabony defects of patients with chronic periodontitis: A randomized controlled clinical trial
p. 69
HG Pirebas, MK Hendek, U Kisa, M Yalim, EO Erdemir
DOI
:10.4103/1119-3077.224795
PMID
:29411727
Aim:
The aim of this double-blinded, randomized, controlled clinical study was to investigate the effect of titanium-prepared platelet-rich fibrin (T-PRF) treatment on the angiogenic biomarkers in gingival crevicular fluid (GCF) in infrabony defects of patients with chronic periodontitis.
Materials and Methods:
Twenty five systemically healthy participants who complied with inclusion criteria with periodontal infrabony defects were recruited. In each patient, the infrabony defect of one side of arch was designated as control group (allograft), whereas the infrabony defect on the contralateral side of same arch was designated as test group (allograft + T-PRF). The therapy methods (test or control) were randomly decided. GCF samples were collected at baseline (presurgery) and then the 3rd, 7th, 14th, and 30th days after surgery. Platelet-derived growth factor (PDGF)-BB, vascular endothelial growth factor (VEGF)-A, fibroblast growth factor (FGF)-2, anjiogenin (ANG), angiostatin (ANT) in the GCF samples were measured using human enzyme-linked immunosorbent assay kits.
Results:
In both groups, total amounts of PDGF-BB, VEGF-A, FGF-2, ANG, and ANT peaked in the GCF samples obtained at the early postoperative day (day 3) and decreased over time in the samples obtained at the 7th, 14th, and 30th days postsurgery. There were no significant differences between groups for the total amounts of PDGF-BB, VEGF-A, FGF-2, ANG, and ANT at all evaluation periods.
Conclusion:
Application of T-PRF combined with allograft in infrabony defects of patients with chronic periodontitis had no significant effects on angiogenic biomarkers in GCF.
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A comparative scanning electron microscopy evaluation of smear layer removal with chitosan and MTAD
p. 76
H Zhou, Q Li, L Wei, S Huang, S Zhao
DOI
:10.4103/1119-3077.224798
PMID
:29411728
The aim of the present study was to compare the efficacy of chitosan and MTAD for the smear layer removal from the root canal through a scanning electron microscope (SEM). Thirty teeth were randomly divided into three groups according to the final irrigants: 0.2% chitosan, MTAD, saline (control group). After the mechanical preparation, the samples were irrigated with saline (control group), 0.2% chitosan and MTDA respectively. Then, the samples were split and the smear layer at the apical, middle, and coronal thirds of each root canal was imaged using SEM. The statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U test (α = 5%). The difference between chitosan and MTDA was statistically significant in the apical region (
p
< 0.05), no significant difference was obtained in the coronal and middle regions in these two experiment groups (
p
> 0.05). The control group exhibited the lowest efficacy in smear layer removal in all regions. Thus, from the result of the present study, we may conclude that chitosan was more effective in smear layer removal than MTAD especially in the apical third.
Context:
Irrigation, which serves a variety of purposes including antibacterial action, tissue dissolution, cleaning and chelating, plays a centric role in the final success of root canal treatment. Thus, more and more attention has been put on the improvement and development of various irrigation techniques or systems.
Aims:
The aim of the present study was to compare the efficacy of chitosan and MTAD for the smear layer removal from the root canal through scanning electron microscopy (SEM).
Settings and Design:
Thirty single-canal premolars were instrumented with rotary-files and then, randomly assigned to test groups which were irrigated with chitosan and MTDA, and control group was treated with saline. Thereafter, the efficacy of smear layer removal was evaluated by SEM.
Materials and Methods:
Thirty teeth were randomly divided into three groups according to the final irrigants: 0.2% chitosan, MTAD, saline (control group). After the mechanical preparation, the samples were irrigated with saline (control group), 0.2% chitosan and MTDA respectively. Then, the samples were split and the smear layer at the apical, middle, and coronal thirds of each root canal was imaged using SEM.
Statistical analysis used:
Kruskal-Walli test and Mann-Whitney U test
Results:
The difference between chitosan and MTDA was statistically significant in the apical regions (
p
< 0.05), no significant difference was obtained in the coronal and middle regions in these two experiment groups (
p
> 0.05). The control group exhibited the lowest efficacy in smear layer removal in all regions.
Conclusion:
Thus, from the result of present study, we may conclude that chitosan was more effective in smear layer removal than MTAD, especially in the apical third.
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Fecal carriage of extended-spectrum beta-lactamase and ampc beta-lactamase-producing enterobacteriaceae in a turkish community
p. 81
G Hazirolan, I Mumcuoglu, G Altan, BB Özmen, N Aksu, ZC Karahan
DOI
:10.4103/njcp.njcp_79_17
PMID
:29411729
Background:
Community-acquired infection caused by extended-spectrum beta-lactamase (ESBL)-producing microorganisms has an increasing frequency.
Aim:
The aim of this study was to determine the fecal carriage of ESBL and AmpC beta-lactamase-producing Enterobacteriaceae in community and to investigate cefotaxime-M (CTX-M) genes among ESBL isolates.
Materials and Methods:
A total of 1402 fecal specimens which were collected from outpatients included in the study. ESBL screening, ESBL production, and AmpC beta-lactamase detection were performed. Matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) was used for identification of species. Antibiotic susceptibilities of the isolates were detected by disk diffusion method. CTX-M beta-lactamase genes were investigated by polymerase chain reaction.
Results:
During the study period, a total of 1402 fecal samples were analysed with ESBL screening test and 490 Enterobacteriaceae strains isolated from these samples (
Escherichia coli
[
n
= 461, 94.1%],
Klebsiella pneumoniae
[
n
= 25, 5.1%], and
Enterobacter cloacae
[
n
= 4, 0.8%]). Fecal carriage of ESBL-producing Enterobacteriaceae in the community was 34.3%. AmpC beta-lactamases were detected in 26 (5.3%), and the frequency of CTX-M was found as 96.9%. The resistance rates of the
E. coli
strains to fluoroquinolones, trimethoprim–sulfamethoxazole, and carbapenems were 31.2%, 33.3%, and 0%, respectively.
Conclusion:
The relative high prevalence of fecal carriage of ESBL-producing bacteria in community warrants further study in this field including developing policies about antimicrobial use and close monitoring of resistance patterns.
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Where we are in the fight against Hepatitis B Infection; Trends in Hepatitis B virus seroprevalence in Black Sea Region of Turkey
p. 87
FA Igde, H Taskin, M Igde, Z Yazici, A Atilla
DOI
:10.4103/njcp.njcp_368_16
PMID
:29411730
Context:
To determine new strategies for complete coverage of hepatitis B virus (HBV) vaccination, every country needs to take into concern factors of infection transmission in its own region.
Aims:
The aim of this study was to investigate the seroprevalence of hepatitis B among all age groups in northern Turkey using HBsAg and anti-HBs serological markers.
Materials and Methods:
The laboratory records of a total of 101648 patients of all ages attending a tertiary level hospital in Samsun, a Black Sea coastal city, between January 2014 and May 2016 were evaluated retrospectively.
Results:
HBsAg and anti-HBs seropositivity was found to be 4% and 38.3%, respectively. There was a significant difference between HBsAg (
χ2
= 209.08;
P
= 0.00), anti-HBs (
χ2
= 124.12;
P
= 0.00) seropositivity, and immunization status. Although we found a statically difference between men and women (
χ2
= 32.2
P
= 0.00) for HBsAg seropositivity, there was no significant difference for anti-HBs (
P
= 0.22). In 1998, the universal infant immunization program changed the HBV epidemiology in Turkey, and resulted in an apparent trend towards reduced disease levels. However, prevalence of HBV infection is still high in adolescent and young adults.
Conclusions:
Therefore, a catch-up immunization program, education, and follow-up policy for these groups, in addition to routine infant immunization, will decrease the HBV infection rate, reducing morbidity and mortality rates, and will help to reduce hepatitis B transmission in Turkey.
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Bonding strength of universal adhesives to Er,Cr:YSGG Laser-Irradiated Dentin
p. 93
MK Ayar, F Erdermir
DOI
:10.4103/1119-3077.224792
PMID
:29411731
Objectives:
Universal adhesives have been recently introduced for use as self-etch or etch-and-rinse adhesives depending on the dental substrate and clinical condition. However, their bonding effectiveness to laser-irradiated dentin is still not well known. Therefore, the aim of this study was to compare the shear bond strength (SBS) of two universal adhesives (Single Bond Universal, Nova Compo-B Plus) applied following laser-etching with SBS of the same adhesives applied in self-etch and acid-etch modes, respectively.
Materials and Methods:
Sixty bovine incisors were used to obtain the flattened dentin surfaces. Specimens were divided into two groups according to universal adhesives. Each universal adhesive was applied with one of the following modes, self-etch, acid-etch, or laser-etch (
n
= 10). Er,Cr:YSGG laser was used for laser-etching with 1.5 W–20 Hz parameters. After adhesive applications and composite buildups, SBS was determined after storage in water for 24 h using a universal testing machine with a crosshead speed of 0.5 mm/min. Failure modes were evaluated using a stereomicroscope. Data were analyzed using two-way of analyses of variances (ANOVA) (
P
= 0.05).
Results:
Two-way ANOVA revealed that adhesive had no effect on SBS (
P
> 0.05), but application mode significantly influenced SBS (
P
< 0.001). Laser-etch significantly increased SBS for NCP when compared to self-etch mode, whereas laser-etch provided similar SBS with self-etch mode for SBU.
Conclusions:
The influence of different application modes on dentin bond strength of universal adhesives was dependent on the adhesive material.
Clinical Significance:
For universal adhesives, laser etching may provide some benefits on bonds strength but this would depend on product.
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Street drug use among emergency patients in a Public Hospital in Turkey
p. 99
FT Caliskan, I Toker, R Toktas, Z Temizyurek, O Unek, B Zirek, O Karcioglu
DOI
:10.4103/njcp.njcp_227_16
PMID
:29411732
Background:
Country-specific numbers of street drug (SD) users are well documented. However, little data exists regarding these patients' clinical presentations and outcomes in the emergency department (ED). Therefore, management of these patients in the emergency setting is still a subject of debate.
Objectives:
The aim of this study is to determine the symptoms and signs of SD users presenting to the ED, and to report the substances, treatments, and outcomes.
Materials and Methods:
In this single-center study, symptoms, clinical findings, diagnoses, and outcomes of patients who reported to have used SDs or were diagnosed as SD users were investigated within a 1-year study period. Chi-square and Mann-Whitney U tests were performed to compare independent variables.
Results:
Mean age of the 425 study patients was 25 ± 9 years (range: 12-64 years), and 6.1% (
n
= 26) of the patients were females. SDs used before presentation to the ED were mostly synthetic cannabinoids and “ecstasy.” Overall prevalence of SD user admissions in ED was 0.24%. The most common presenting complaint was weakness/faintness in 21.1% (
n
= 90). Depressed level of consciousness was the most common physical sign (33.3%,
n
= 142). Incidences of altered mental status were significantly higher among ecstasy and/or bonsai users (
n
= 14, 27.5%;
P
= 0.027 and
n
= 46, 64.8%;
P
< 0.001, respectively), compared to other SD users. While 23.1% (
n
= 98) of the SD users did not warrant any medical intervention, 6.6% of the users (
n
= 28) underwent advanced life support.
Conclusions:
Self-reported SD users were mostly young males who were treated symptomatically and discharged. Almost one-third-mostly ecstasy and bonsai users-had depressed level of consciousness and required resuscitation.
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Preoperative platelettolymphocyte ratio as a prognostic factor in geriatric patients with proximal femoral fractures
p. 107
H Göçer, A Çıraklı, İ Büyükceren, M Kılıç, AS Genç, N Dabak
DOI
:10.4103/1119-3077.224786
PMID
:29411733
Introduction:
The aim of this study was to investigate whether the platelet to lymphocyte ratio is a prognostic factor in geriatric patients who underwent surgery for proximal femoral fractures.
Materials and Methods:
Clinical and laboratory data of 288 patients who underwent surgery for proximal femoral fracture were analysed. The patients were divided into six groups on the basis of sex (male and female) and survival duration after the operation (death within the first 6 months, death between the 6 and 12 months, survival for more than 12 months). Pre-operative platelet/lymphocyte ratios of these groups were compared.
Results:
Of 288 patients, 187 were female and 101 were male. There was no significant difference between the groups with regard to age (
p
= 0.123 female groups) (
p
= 0.207 male groups). Although the preoperative platelet to lymphocyte ratio was higher in patients who died within 12 months than in those who survived beyond that, this platelet/lymphocyte ratio was statistically significant in females who died in the first 6 months (
p
= 0.038).
Conclusion:
A high preoperative platelet to lymphocyte ratio may be associated with high risk of mortality in patients who were operated for proximal femoral fracture.
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CASE REPORTS
Giant pericardial cyst with a growing feature
p. 111
S Çetin, G Heper, MG Vural, T Hazirolan, F Tanrikulu, E Gülhan
DOI
:10.4103/njcp.njcp_66_17
PMID
:29411734
Pericardial cysts are rare and benign lesions of the heart. They are usually asymptomatic and diagnosed incidentally on echocardiography or chest X-ray. In this report, we present an extremely rare case of a symptomatic giant pericardial cyst (11.6 cm × 10.6 cm × 8 cm) of a 55-year-old male patient who was admitted to our cardiology clinic. A thoracic computed tomography (CT) in 2013 revealed a giant pericardial cyst. However, at that time, the patient was asymptomatic and follow-up was recommended. Recent thoracic CT and magnetic resonance imaging demonstrated a significantly growing feature of this cyst with impending possible complications.
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The importance of early diagnosis of gardner's syndrome in dental examination
p. 114
MZ Adisen, A Okkesim, M Misirlioglu
DOI
:10.4103/njcp.njcp_381_16
PMID
:29411735
Gardner syndrome (GS) is a rare genetic disorder. Dentists play an important role in diagnosis considering that craniomaxillofacial osteomas are a major criteria for GS. We report a 26-year-old male patient who referred to our department with toothache. On routine panoramic radiographic examination, multiple radiopaque masses were detected incidentally. In addition, on extraoral examination, a soft tissue tumor was detected on his shoulder. The patient was referred to the gastroenterology department and intestinal polyps were detected in the colon. Histopathology report revealed malignant changes in the intestinal polyps. Early colectomy, which is a life-saving operation, was possible because of our early diagnosis.
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LETTER TO EDITOR
Depression and posttraumatic stress disorder among road traffic accident victims managed in a tertiary hospital in Southern Nigeria: The methodological issue
p. 117
R Ramazani, A Fayaz-Bakhsh, F Moradpor, M Khaledian
DOI
:10.4103/njcp.njcp_293_17
PMID
:29411736
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© Nigerian Journal of Clinical Practice | Published by Wolters Kluwer -
Medknow
Online since 10
th
November, 2010