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Table of Contents
August 2018
Volume 21 | Issue 8
Page Nos. 949-1085
Online since Thursday, August 2, 2018
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ORIGINAL ARTICLES
Effects of bilateral breast reduction on peak airway pressure and pulmonary function tests
p. 949
AA Onuk, D Senen, B Arslan, U Muslu, M Tek, B Karslı
DOI
:10.4103/1119-3077.238420
PMID
:30073993
Purpose:
Surgical reduction due to breast size is not carried out merely for anesthetic concerns but also for such complaints as breast pain belonging to breast and skeletal system, back pain, neck pain, and intertriginous rashes. This study aims to investigate the effect of bilateral breast reduction surgery on maximum inspiratory pressure (Ppeak) and pulmonary functions. This study aims to investigate the effect of bilateral breast reduction surgery on pulmonary function test.
Methods:
The study included 50 patients who would undergo bilateral breast reduction. Patients were divided into two groups: group II were given positive end-expiratory pressure (PEEP), which was not administered to the group I. Patients were checked in terms of maximum inspiratory pressures (Ppeak) before surgery, after first and second breasts were removed, and after surgery. Pulmonary function tests were carried out on preoperative, postoperative second and 14
th
days. As RFT, forced vital capacity (FVC), FEV1 (forced expiratory volume at the first second of FVC), FEV1/FVC and PEF (peak expiratory flow rate) were measured.
Results:
In both groups, demographic data were not found to statistically significant differences (
P
> 0.05). When compared both groups in terms of preoperative FVC and FEV1/FVC 14
th
day, a significant increase was found on the 14
th
day (
P
< 0.05). A significant difference was not established between groups in terms of Ppeak values (
P
> 0.05). Ppeak was found to be significantly higher in group I (22.28 ± 7.56) at the end of intubation compared with group II (19.04 ± 3.73) (
P
= 0.002,
P
< 0.05). Similarly, preoperative Ppeak was established to be 21.88 ± 7.51 in group I and it was significantly higher compared with group II (19.44 ± 4.08), (
P
= 0.002,
P
< 0.05). When compared Ppeak values at the end of intubation and before operation with entry values a statistically significant difference was not found in either group (
P
= 0.76,
P
> 0.05).
Conclusions:
Some researchers reported a positive correlation between FVC, FEV1/FVC, and PEF along with the excised tissue mass. We established a positive correlation between the excised tissue weight and FVC and FEV1/FVC and that PEEP application did not have an impact on Ppeak.
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Evaluation of the effect of apical lesion on mucosal thickening and thickness of apical bone using limited cone-beam computed tomography
p. 954
N Kocak, E Alpoz, H Boyacioglu
DOI
:10.4103/njcp.njcp_307_17
PMID
:30073994
Objective:
The purpose of this study was to evaluate the effect of periapical lesion size on the degree of mucosal thickening of maxillary sinus and thickness of apical bone using cone-beam computed tomography.
Materials and Methods:
In Group 1 (teeth with apical lesions), diameter of apical lesion, width of apical bone, thickness of Schneiderian membrane; for Group 2 (teeth without apical lesions), width of apical bone in long axis of root and thickness of Schneiderian membrane were measured on coronal and sagittal images.
Results:
Mann–Whitney U-test revealed no significant difference between two groups regarding mucosal thickening and apical bone measurements (
P
> 0.05). Wilcoxon signed-rank test showed no significant difference between the measurements in sagittal and coronal slices (
P
> 0.05).
Conclusion:
Results of the present study showed that Schneiderian membrane near the maxillary premolars and molars with apical lesions is not significantly thicker compared to teeth without apical lesions.
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Ultrasound measurement of fetal kidney length in normal pregnancy and correlation with gestational age
p. 960
JP Edevbie, AO Akhigbe
DOI
:10.4103/njcp.njcp_373_15
PMID
:30073995
Background:
Belated booking for antenatal care remains a common practice among pregnant women in developing countries. Many of the existing conventional ultrasonographic indices used for assessing gestational age (GA) become increasingly unreliable beyond the 2
nd
trimester.
Materials and Methods:
A prospective cross-sectional study of booked healthy pregnant women with regular menstrual cycles and certain last menstrual period (LMP) were examined using ultrasound over a 6-month period. Fetal kidney length (FKL) was measured, beginning from 20 to 41 weeks of gestation.
Results:
A total of 400 pregnant women were examined. The mean left FKL was slightly but significantly higher than the mean right FKL across the various weeks of gestation (
P
< 0.05). The mean combined FKL (MKL) was 32.18 ± 5.96 mm, with a reference range of 20.87 ± 0.75 mm to 41.41 ± 0.07 mm from 20 to 41 weeks of gestation. There was strongly positive significant correlation between MKL in millimeters and GA by the LMP in weeks (
r
= 0.997,
P
= 0.000). The standard error of prediction (SE) of GA was least for MKL (±7.17 days), followed by femur length (FL) (±8.38 days), head circumference (HC) (±9.02 days), abdominal circumference (AC) (±9.14 days), and biparietal diameter (BPD) (±10.36 days). The best multiple regression model for predicting GA included the five variables such as MKL, FL, BPD, HC, and AC, with a SE of prediction of (±6.31 days).
Conclusion:
FKL can serve as an additional reliable parameter for accurate dating of GA during obstetric scan.
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TP53
polymorphisms in smokers' and nonsmokers' pericoronal follicles of asymptomatic impacted third molars
p. 967
E Burhanoglu, MC Aksoy, PA Kosar
DOI
:10.4103/njcp.njcp_434_17
PMID
:30073996
Background and Purpose:
The investigators designed and implemented a prospective cohort study composed of smoking and nonsmoking patients with asymptomatic fully impacted mandibular third molars. The objective of the paper was to evaluate 21 single-nucleotide polymorphisms (SNP) on the
TP53
gene in smokers' (S) and nonsmokers' (NS) pericoronal follicles of asymptomatic impacted third molars.
Materials and Methods:
Matrix-assisted desorption/ionization time of the flight mass spectrometry was used for SNP analysis of 21 regions in the
TP53
gene. Descriptive statistics and Chi-square tests were computed with a
P
value of 0.05.
Results
: Ten of the 21 SNPs related to oral pathologies according to NCBI dbSNP, were detected; in these, the genotypic frequencies showed no differences between the S and NS groups (
P
> 0.05). The results showed a high ratio of SNPs without correlation between smoking and
TP53
gene status.
Conclusion:
Further studies should examine the entire
TP53
gene to elucidate how smoking affects it in larger study populations.
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Modified simple decompression of ulnar nerve in the treatment of cubital tunnel syndrome: Report of a series of cases
p. 974
M Balevi, S Ozturk
DOI
:10.4103/njcp.njcp_198_17
PMID
:30073997
Background/Aim:
Ulnar compressive neuropathy is the second most common nerve compression in the upper extremity. Although numerous operative procedures have been defined for the treatment of cubital tunnel syndrome (CuTS), the best operative intervention remains controversial. The aim of this study is to discuss the efficacy of a modified simple decompression (MSD) of the ulnar nerve in the treatment of CuTS.
Materials and Methods:
Each patient was preoperatively examined, and the following data were recorded: initial complaint, duration of symptoms, and presence of Tinel's sign around the elbow, results of provocation by the elbow flexion test, and results of electrodiagnostic studies. Patients' preoperative clinical manifestations were determined based on Dellon's staging system and Bishop scores. Pre- and post-operative motor conduction velocity (MCV) of the ulnar nerve were also recorded. Under the regional anesthesia, 4 cm long curved skin incision, above and below the elbow, was made posterior to the medial epicondyle of the humerus and the ulnar nerve was seen. The nerve was released proximally as it passed through the medial intermuscular septum. The cubital tunnel retinaculum and flexor carpi ulnaris aponeurosis were then cut distally. Only the compressive fascial bands are released. Then, the cubital tunnel reticulum was sutured to subcutaneous tissue loosely to prevent subluxation of the ulnar nerve.
Results:
A total of 15 patients were operated. Postoperative electrophysiological study assessed at 3 months following surgery in 8 patients. In 7 of these patients (86%), the mean value of MCV had improved from 38.9 ± 12.0 m/s to 48.1 ± 11.9 m/s (
P
< 0.05). According to Bishop scoring system, 13 patients (86.7%) were clinically graded as excellent, 1 patient (6.7%) was graded as good, and only 1 patient (6.7%) was graded as fair.
Conclusion:
MSD is a technically simple, safe, and effective method without annoying complications.
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A survey on awareness, knowledge, and attitudes toward epilepsy in an urban community in Turkey
p. 979
C Macit, PM Clark, N Taner, C Bingol, G Mercanoglu, G Yuksel
DOI
:10.4103/njcp.njcp_199_17
PMID
:30073998
Background and Aim:
Epilepsy is one of the most common chronic neurological disorders with a high prevalence. Epileptic people and their family members suffer more from social stigma than the disorder itself. Among various complex reasons knowledge and awareness about epilepsy are the two important factors underlying discriminatory attitudes towards epileptic people. Community pharmacists play a major role in the care of these patients. In this study we mainly aimed to gain insights into the knowledge and awareness of and attitudes (AKA) towards epilepsy both in epileptic and healthy individuals in an urban community. To this end we also aimed at developing a reliable and valid measurement tool to assess AKA levels.
Materials and Methods:
This study was conducted in 13 community pharmacies with 219 respondents. Factor analysis yielded three clear subscales.
Results:
It was found that a vast majority of the participants were familiar with epilepsy; yet only 18 of them had detailed information. The community pharmacists were indicated as a main source of information about epilepsy at the same rate to that of physicians. Although most of the respondents knew that epilepsy was not a form of mental illness only about one forth of them knew the real cause. More than half of the respondents supported the epileptics' socialization in the community.
Conclusion:
We believe that the questionnaire developed in the study is a promising instrument for determining educational needs and offering guidance to healthcare professionals in developing standardized educational tools and programs.
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The effect of female age on the outcome of intrauterine insemination treatment in a public hospital-assisted reproduction technology unit
p. 988
J Osaikhuwuomwan, A Osemwenkha, O Iribhogbe, M Aziken, A Orhue
DOI
:10.4103/njcp.njcp_248_16
PMID
:30073999
Objective:
The objective of the study is to evaluate the effect of female age on the outcome of ovarian stimulation (OS) and intrauterine insemination (IUI) treatment.
Methodology:
This was a 36 months' retrospective analysis of all IUI treatment cycles with prior OS. Based on the age of the women, 4 groups were identified for comparative analysis, namely women below 30 years, between 30 and 34; 35–39 years, and women aged 40 years and beyond.
Results:
Two hundred and seventeen IUI procedures were conducted during the study and 39 had a positive pregnancy test outcome (a pregnancy rate of 18%). Majority of the women were 35–39 years (41.5%), while 12% were 40 years and above. The pattern showed that the pregnancy rate was highest in the younger age group who were below 30 years, 6/18 (33.3%) and 30–34 years, 19/83 (22.9%) compared with women 35–39 years, 12/90 (13.3%) and ≥40 years, 2/26 (7.7%). The difference in the linear association of each age class compared to the next was significant (
P
= 0.06 and
P
= 0.007, respectively). The trend revealed that baseline follicle stimulating hormone increased with age and the youngest age group required significantly fewer units of human menopausal gonadotropin to achieve adequate response to OS compared to the oldest age group (
P
< 0.001).
Conclusion:
Advanced age negatively affects OS and IUI outcome. Treatment is associated with better pregnancy outcome in women under 35 years compared to women who were 40 years and beyond. This fact should be clearly emphasized at counseling of the 40-year-old that may opt for IUI treatment.
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Relationship between corneal biomechanical properties among pregnant women in a tertiary hospital in Nigeria
p. 993
NZ Nwachukwu, OI Okoye, Obiekwe Okoye, CC Eze, DC Nwachukwu, UI Nwagha, RE Umeh
DOI
:10.4103/njcp.njcp_381_17
PMID
:30074000
Objective:
In Nigeria, many pregnant women as well as health-care providers are unaware of the effect of pregnancy on the eye. The present study investigated the changes in central corneal thickness (CCT), corneal sensitivity (CS), and intraocular pressure (IOP) among pregnant women in a tertiary hospital in Nigeria and the relationship between them.
Materials and Methods:
A prospective longitudinal study was used. One hundred and thirty-four pregnant women attending the Obstetric Clinic of the University of Nigeria Teaching Hospital, Enugu, were consecutively recruited in their second trimester for the study. Changes in CCT, CS, and IOP were monitored at the second and third trimesters and 6-week postpartum. Data obtained were analyzed using Statistical Package for the Social Sciences version 20. The effect of duration of pregnancy on these variables was determined using simple linear regression and further analysis was done using Bonferroni's
post hoc
test.
Results:
The women were aged 18–48 years, with a mean age of 30.81(±5.49) years and majority of them (61.2%) were multigravida. The duration of pregnancy varied inversely and significantly with CS (
P
< 0.05) and IOP (
P
< 0.000) with the least values recorded in the third trimester, while it varied directly and also significantly with CCT (
P
< 0.000) with the highest value obtained in the third trimester. A negative correlation that was significant only in third trimester was found between CCT and IOP (
P
< 0.02) and CS (
P
< 0.03).
Conclusion:
There was a progressive increase in CCT with a corresponding decrease in CS and IOP across the trimesters of pregnancy, but these changes reversed 6-week postpartum.
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Effect of sandblasting, silica coating, and erbium: Yttrium-Aluminum-Garnet laser treatment on the shear bond strength of self-adhesive resin cement to alumina ceramics
p. 1000
I Caglar, SM Ates, Y Boztoprak, YU Aslan, Z Yesil Duymus
DOI
:10.4103/njcp.njcp_300_17
PMID
:30074001
Objective:
The aim of this study was to investigate the different surface treatments on the bond strength of self-adhesive resin cement to high-strength ceramic.
Materials and Methods:
Ninety aluminum oxide ceramic (Turkom-Ceramic Sdn. Bhd., Kuala Lumpur, Malaysia) specimens were produced and divided into nine groups to receive the following surface treatments: control group, no treatment (Group C), sandblasting (Group B), silica coating (Group S), erbium: yttrium-aluminum-garnet (Er:YAG) laser irradiation at 150 mJ 10 Hz (Group L1), Er:YAG laser irradiation at 300 mJ 10 Hz (Group L2), sandblasting + L1 (Group BL1), sandblasting + L2 (Group BL2), silica coating + L1 (Group SL1), and silica coating + L2 (Group SL2). After surface treatments, surface roughness (SR) values were measured and surface topography was evaluated. Resin cement was applied on the specimen surface, and shear bond strength (SBS) tests were performed. Data were statistically analyzed using one-way ANOVA and Tukey's multiple comparisons at a significance level of
P
< 0.05.
Results:
Group S, SL1, and SL2 showed significantly increased SR values compared to the control group (
P
< 0.05); therefore, no significant differences were found among the SR values of Groups B, BL1, BL2, L1, and L2 and the control group (
P
> 0.05). Group S showed the highest SBS values, whereas the control group showed the lowest SBS values.
Conclusion:
Silica coating is the most effective method for resin bonding of high strength ceramic, but Er:YAG laser application decreased the effectiveness.
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Effect of radiotherapy on the coronal-sealing ability of two different root canal sealing materials
p. 1008
E Hazar Bodrumlu, E Bodrumlu
DOI
:10.4103/njcp.njcp_377_17
PMID
:30074002
Objective:
This study aimed to assess the coronal-sealing ability of two different root canal obturation materials: gutta-percha with AH Plus and Resilon with Epiphany SE between radiated and nonirradiated groups.
Materials and Methods:
Fifty-six extracted premolar teeth were randomly divided into two main groups according to the presence or absence of radiotherapy. Specimens were divided into two equal groups. In the radiotherapy group, a total dose of 60 Gy was delivered with 1.8 Gy/d fractions, 5 days a week, for 35 days. The root canals were obturated with either gutta-percha/AH Plus or Resilon/Epiphany SE canal sealer. The samples were then evaluated for the coronal-sealing ability using a centrifuging dye penetration test at 3000 rpm for 5 min in a 2% Rhodamine B solution. The degree of dye penetration was evaluated with a stereomicroscope.
Results:
Although the sealing ability of both groups was not affected in radiotherapy, the coronal leakage values of Resilon/Epiphany SE slightly increased when radiation was applied (
P
> 0.05).
Conclusion:
Radiotherapy does not significantly affect the coronal-sealing ability of root canal obturation materials, gutta-percha/AH Plus and Resilon/Epiphany SE.
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Subclinical atherosclerosis and impaired cardiac autonomic control in pediatric patients with Vitamin B12 deficiency
p. 1012
SF Celik, E Celik
DOI
:10.4103/njcp.njcp_345_17
PMID
:30074003
Objective:
Homocysteine (Hcy) is an independent risk factor for predisposing to atherosclerosis and endothelial dysfunction. Hcy levels increase with Vitamin B12 deficiency. The aim of this study was to investigate the association between carotid intima-media thickness (CIMT) and the autonomic modulation of heart rate variability (HRV) in early detection of atherosclerosis and impaired cardiac autonomic control in pediatric patients with Vitamin B12 deficiency.
Materials and Methods:
Sixty patients with Vitamin B12 deficiency (14.4 ± 1.72 years, 36 female) and 40, age, sex, and body mass index-matched healthy controls (13.4 ± 1.86 years, 24 female) had performed 24-h Holter monitoring, carotid ultrasonography, and echocardiography. Linear regression models assessed associations between to HRV parameters and CIMT and the blood markers.
Results:
We defined Vitamin B12 deficiency as a serum level, 200 pg/mL. Hcy (
P
< 0.001) and CIMT (
P
< 0.001) levels were significantly higher in the patient group compared with the control group. Hcy level was found to be the most important independent variable affecting CIMT. Each 1 degree increase in Hcy, it was observed that the CIMT value increased by 0.01 mm (B = 0.01;
t
= −2.39;
P
< 0.05). Low-frequency power (LF), high-frequency power (HF) (
P
< 0.001), and the square root of the mean of the squared differences of two consecutive RR intervals (rMSSd) (
P
= 0.04) were significantly lower in the B12 deficient patients. Furthermore, Hcy level was found to be the most important independent variable affecting LF, HF, and rMSSd.
Conclusions:
Subclinical atherosclerosis was associated with cardiovascular autonomic imbalance in pediatric patients with Vitamin B12 deficiency. Homocysteinemia may be an important marker for the prediction of future cardiovascular disease.
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Vulvovaginal candidiasis in reproductive age women in Enugu Nigeria, clinical versus laboratory-assisted diagnosis
p. 1017
UU Aniebue, TO Nwankwo, MI Nwafor
DOI
:10.4103/njcp.njcp_25_16
PMID
:30074004
Background:
Clinical diagnosis of acute vulvovaginal candidiasis (VVC) depends on evidence of clinical symptoms, but symptomatic treatment widely practiced in low-resource area may lead to overdiagnosis and treatment.
Objective:
The objective of the study is to determine the prevalence of VVC among women attending gynecological clinic in University of Nigeria Teaching Hospital (UNTH) Enugu and the accuracy of clinical-based diagnosis versus laboratory test supported diagnosis and patients' characteristics that affect accuracy.
Materials and Methods:
This study surveyed patients seen in a gynecologic clinic for VVC using a semi-structured, pretested, and interviewer-administered questionnaire. Vaginal examination was done on each patient and findings documented. A pair of swabs was taken from the vagina and cervical os and cultured for
Candida
species using Sabouraud Dexttose Agar. Data were analyzed using statistical software, SPSS version 15 (SPSS Inc., Chicago IL, USA).
P
≤ 0.05 were considered to be statistically significant.
Results:
The mean age of 209 women surveyed was 35.9 (standard deviation [SD] ±9.0) years. Their mean parity was 2 (SD ± 3). The prevalence of VVC was 17.7% based on symptoms and laboratory test. Clinically based diagnosis had a sensitivity of 70.3% and specificity of 83.7%. Forty-one (19.6%) of the study population had good knowledge of VVC. More than 44% of the women had self-reported and treated VVC within the year. Young women of 24 years or less (54.5%) and those who had reported other episodes of VVC within the past year (41.1%) were most commonly associated with inaccurate clinical diagnosis.
Conclusion:
Clinically based diagnosis of VVC has an unacceptably high false-positive rate which may encourage continued presumptive treatment with its attendant risks. Clinical evaluation and laboratory culture of vulvovaginal specimen should be the standard diagnostic method.
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Retrospective evaluation of adult poisoning cases admitted to emergency department of a University Hospital in Turkey
p. 1023
S Sungur, U Bilge, N Acar, I Unluoglu
DOI
:10.4103/njcp.njcp_291_17
PMID
:30074005
Objective:
We aimed to evaluate demographic, etiological, clinical features, and prognosis of poisoning cases applied to a tertiary emergency department retrospectively.
Materials and Methods:
The recordings of poisoning cases aged 18 years old and over which applied to the department of emergency medicine between the dates of 2010–2015 were examined. Age, gender, admission date, amount of time passed since exposure to the poisonous substance, application method, cause of poisoning, laboratory findings at arrival, vital signs, type of poisonous substance, the way of taking, treatment method in urgent care, consultation need, and the outcome of cases were recorded.
Results:
Of the poisoning cases, 437 (52.1%) were female, and 402 (47.9%) were male. The mean age was calculated as 33.50. When the cause of poisonings are examined; 456 patients were found to be poisoned by a suicide attempt, 350 were accidentally poisoned, and 33 were poisoned by treatment complication. As the causing substance of poisoning, medicinal drugs were found in 465 cases (55.4%), carbon monoxide in 205 cases (24.4%), and narcotics in 119 cases (14.2%). Of medicinal drug poisonings, 221 (46.8%) were multiple drug intake. It was seen that 46.6% of the patients were kept under observation with only symptomatic treatment while nasogastric lavage and activated charcoal were applied in 40.2% of them.
Conclusion:
It can be suggested that poisonings are encountered more commonly in young people, especially in women, with medicinal drugs and for suicidal purposes. Drugs detected at high rates in poisonings, such as painkillers and antidepressants, should be used more cautiously.
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Iontophoresis and topical application of 8% arginine-calcium carbonate to treat dentinal hypersensitivity
p. 1029
S Kumar, BS Thomas, K Gupta, V Guddattu, Mohan Alexander
DOI
:10.4103/njcp.njcp_341_17
PMID
:30074006
Aim and objectives:
The aim and the objectives were. (1) to assess the efficacy of a desensitizing toothpaste containing 8.0% arginine-calcium carbonate (Colgate® Sensitive Pro-Relief™), (2) to assess the efficacy of a desensitizing toothpaste containing 8.0% arginine-calcium carbonate (Colgate® Sensitive Pro-Relief™) used in combination with iontophoresis, and (3) to compare the effectiveness of the above methods.
Subjects and Methods:
Two groups of 40 patients each having dentinal hypersensitivity were treated using 8% proarginine and iontophoresis. The patients were recalled after 1, 2, and 4 weeks. The scores were tabulated and the results were analyzed using SPSS statistical software.
Results:
Visual analog scale between the two groups showed a significant difference from the 1
st
week till the 4
th
week. ANOVA values showed the reduction in the dentinal hypersensitivity in Group 2 using the iontophoresis along with the 8.0% arginine-calcium carbonate toothpaste. The Cochran–Mantel–Haenszel correlation test of the Schiff's dentinal hypersensitivity cross-tabulation showed
P
< 0.001 which was statistically significant reduction after the 4
th
week following the application of 8.0% arginine-calcium carbonate along with iontophoresis.
Conclusion:
Iontophoresis, when used along with Colgate® Sensitive Pro-Relief™ toothpaste, can provide additional benefit as this provides a better sealing effect.
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Microleakage of glass ionomer based restorative materials in primary teeth: An
In vitro
study
p. 1034
B Ayna, S Celenk, O Atas, EC Tümen, E Uysal, IR Toptanci
DOI
:10.4103/njcp.njcp_143_17
PMID
:30074007
Aim:
Using AutoCAD, we examined the microleakage of dye at the edges of primary-teeth restorations using three glass ionomer-based restorative materials.
Materials and Methods:
A total of 30 extracted noncarious primary molars were used. Class V cavities were adjusted on the buccal surfaces. The teeth were randomly divided into three groups of 10 teeth each as follows: Group A (Ketac Molar), Group B (Photac Fil), and Group C (Dyract XP). All specimens were stored for 24 h at 37°C in distilled water. The teeth were thermocycled 1000 times between 5°C ± 2°C and 55°C ± 2°C before immersion in 0.5% basic fuchsin for 24 h. Two mesiodistal cuts of each tooth were photographed under a stereomicroscope equipped with a digital camera. The dye-infiltrated surface area was measured. Statistical evaluations were performed by the Kolmogorov–Smirnov test, Levene test, one-way analysis of variance, and Tukey's honestly significant difference test.
Results:
The mean microleakage ratio differed significantly among the groups (
P
< 0.05). Group C exhibited a significantly smaller area (
P
< 0.001) than the other groups. Group A had a nonsignificantly higher mean microleakage value than Group B (
P
> 0.05).
Conclusions:
Polyacid-modified composite resin may be a useful restorative material in primary teeth in terms of minimizing microleakage.
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The relationship between resilience, happiness, and life satisfaction in dental and medical students in Jeddah, Saudi Arabia
p. 1038
KT Aboalshamat, AO Alsiyud, RA Al-Sayed, RS Alreddadi, SS Faqiehi, SA Almehmadi
DOI
:10.4103/njcp.njcp_278_17
PMID
:30074008
Objectives:
Few studies have investigated positive psychological health among medical and dental students. This study aimed to investigate the relationship between resilience, satisfaction with life, and happiness among medical and dental students in private colleges in Jeddah, Saudi Arabia.
Materials and Methods:
A total of 607 participants, from 3
rd
-year students to interns, were involved in a cross-sectional study. Data were collected through a self-reported questionnaire. Resilience was measured by the Resilience Scale-14, happiness was measured by the subjective happiness scale, and life satisfaction was measured by the satisfaction With life scale. Data were analyzed by
t
-test, ANOVA, and linear regression.
Results:
There was a significant correlation between resilience and life satisfaction (
P
< 0.001), and between resilience and happiness (
P
< 0.001). There were 66.3% who have resilience below average and 24.7% who have satisfaction with life below average. Resilience was higher in females, dental students, and students with high family income than it was in the opposite subgroups.
Conclusion:
Students with high resilience are happier and more satisfied with their lives. Establishing programs to help students improve their resilience is recommended.
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Pattern of tympanic membrane perforation in a tertiary hospital in Nigeria
p. 1044
WA Adegbiji, GT Olajide, OA Olajuyin, F Olatoke, CC Nwawolo
DOI
:10.4103/njcp.njcp_380_17
PMID
:30074009
Background/Objectives:
Tympanic membrane perforation is a common otological disorder with associated hearing impairment. This study aimed at determining the clinicoepidemiological pattern, etiological factors, clinical presentation, and management of tympanic membrane perforation in a tertiary hospital in Nigeria.
Materials and Methods:
This was a prospective, hospital-based study of patients with the clinical finding of perforated tympanic membrane. The study was carried out over a period of 5 years (September 2012 to August 2017). Interviewer-assisted questionnaire was administered to obtain the detailed history and clinical findings from consenting patients. Data collected were collated and analyzed using SPSS version 16.0.
Results:
A total of 529 patients had tympanic membrane perforation, of which 368 (69.6%) were males and 161 (30.4%) were females with a male-to-female ratio of 2:1. The prevalence of tympanic membrane perforation in this study was 7.8%. The most common presenting symptom among the patients was otorrhea in 81.5%, otalgia in 72.8%, and tinnitus in 55.7%. Acute suppurative otitis media was a cause of tympanic membrane perforation in 28.4% of the patients while 55.7% of the patients proceed to chronic suppurative otitis media. Unilateral tympanic membrane perforation was 79.0%. The left ear tympanic membrane perforation was 43.9%. Grade 1 tympanic membrane perforation accounted for 39.3% while grade 2 accounted for 32.3%. The most common types of tympanic membrane perforation were central in 38.2%, anterior central in 32.3%, and posterior central in 19.3%. Conductive hearing impairment accounted for 61.6% while sensorineural hearing impairment 25.3%. The most common degrees of hearing impairment were mild and moderate and accounted for 47.1% and 25.1%, respectively. The most common complications of tympanic membrane perforation were hearing impairment in 52.6%. Majority of the patients (425) were treated conservatively, six had fat patches, while 98 were treated surgically. Tympanic membrane perforation healed at the end of 3 months in 81.5%, while 18.5% did not heal after 3 months.
Conclusion:
Tympanic membrane perforation arises mainly from middle ear infections and traumatic causes. At presentation, size and location of perforation vary which depend on duration of infection or the traumatic causes.
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Evaluation of the maxillary third molars and maxillary sinus using cone-beam computed tomography
p. 1050
ZZ Yurdabakan, O Okumus, FN Pekiner
DOI
:10.4103/njcp.njcp_420_17
PMID
:30074010
Objectives:
The purpose of this study was to assess the relationship of the maxillary third molars to the maxillary sinus using cone-beam computed tomography (CBCT) in a Turkish population.
Materials and Methods:
A total of 300 right and 307 left maxillary third molars were examined using CBCT images obtained from 394 patients. Data including the age, gender, the angulation type, depth of the third molars, and horizontal and vertical positions of the maxillary sinus relative to the third molars were examined.
Results:
Among 394 patients, 215 (54.6%) were male and 179 (45.4%) were female. The most common angulation of impaction was vertical (80.2%). Based on the depth of the third molars in relation to the adjacent second molar, Class A was the most common. Regarding the relationships of the third molars with the maxillary sinus, vertical Type I (43.5%) and horizontal Type II (59.3%) were seen most frequently. There was a significant difference between the vertical and horizontal relationships (
P
< 0.05).
Conclusions:
Knowledge of the anatomical relationship between the maxillary sinus floor and maxillary third molar roots is important for removing a maxillary third molar. CBCT evaluation could be valuable when performing dental procedures involving the maxillary third molars.
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Evaluation of patient perceptions after frenectomy operations: A comparison of neodymium-doped yttrium aluminum garnet laser and conventional techniques in the same patients
p. 1059
M Calisir, B Ege
DOI
:10.4103/njcp.njcp_2_18
PMID
:30074011
Background:
The aim of the present study was to compare the level of postoperative discomfort between labial frenectomy done by neodymium-doped yttrium aluminum garnet (Nd: YAG) laser and the conventional technique and evaluate the differences in the levels of postoperative pain and functional complications such as eating and speaking between these two methods.
Materials and Methods:
Forty patients requiring labial frenectomy in both jaws were included in the study. One side of each patient was treated with laser, whereas the other side was treated with the conventional technique and all surgeries were performed by the same surgeon. Postoperative pain and functional complications were evaluated for each patient and recorded using a visual analog scale on the operation day and postoperative 1, 3, 7 and 10 days.
Results:
The results indicated that patients treated with the Nd: YAG laser had lower levels of postoperative pain and were more comfortable while chewing and speaking at the operation day and postoperative 1
st
day (
P
< 0.05).
Conclusion:
The results suggest that Nd: YAG laser application during oral soft-tissue surgery provides better patient perceptions and less postoperative pain compared to conventional surgery.
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The
coa
,
mec
, and
spa
genes diversity among methicillin-resistant
Staphylococcus aureus
Strains from health-care workers and patients
p. 1065
Meshref A Al-Ruwaili
DOI
:10.4103/njcp.njcp_301_17
PMID
:30074012
Background:
Methicillin-resistant
Staphylococcus aureus
(MRSA) is a bacterial pathogen that is frequently isolated in both hospital and community environments. MRSA is considered a major nosocomial pathogen that causes severe morbidity and mortality.
Materials and Methods:
Two hundred and twenty-five nasal swabs were collected (100 from health-care workers and 125 from patients).
S. aureus
was identified by colony morphology in both blood and mannitol salt agars, catalase and coagulase productions, and also by standard biochemical tests. Susceptibility test to several antimicrobial agents was performed by disc diffusion agar according to the Clinical and Laboratory Standards Institute guidelines. The polymerase chain reaction amplification of the
coa
,
mecA
, and
spa
gene was carried out in the clinical isolates showed resistant to oxacillin.
Results:
Among 225 isolates of bacteria, 76 were confirmed to be
S. aureus
by phenotypic characteristics. Thirty isolates were considered MRSA by susceptibility antimicrobial test. Twenty-four were confirmed to be
S. aureus
by the presence of
coa
gene bands. Twenty-one
S. aureus
isolates were confirmed to be MRSA by the presence of
mecA
gene. The
spa
gene in health-care workers was present in 88.88% and for patients was 41.66%.
Conclusions:
This study is suggestive that the PCR for the detection of
coa
,
mecA
, and
spa
gene is a fast, accurate, and valuable diagnostic tool.
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CASE REPORTS
Accidental displacement of mandibular third molar roots into the pterygomandibular space
p. 1075
Y Tamer, ZO Pektas
DOI
:10.4103/njcp.njcp_427_17
PMID
:30074013
The surgical removal of impacted third molars is one of the most common procedures performed in both oral surgery and general dentistry. Accidental displacement of the impacted tooth or root fragments to the adjacent anatomical spaces is a rare but serious complication with even life-threatening complications. This case report presents the diagnosis and surgical management of an accidentally displaced right mandibular third molar root via an intraoral approach.
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Extracranial meningiomas in the head-and-neck region: A 15 years' experience
p. 1078
D Krasic, M Stojanovic, V Petrovic, Z Pesic
DOI
:10.4103/njcp.njcp_439_17
PMID
:30074014
Meningiomas constitute a large group of tumors of the central nervous system, with the prevalence of 18%–20%. Extracranial localization of meningeomas could appear due to their extracranial origin or due to the spreading of intracranial meningeomas. In this paper, we present our 15 years' experience in the diagnosis and treatment of extra- and intracranial meningiomas invading the head-and-neck region. In the period from 2001 to 2016 at our clinic, there were five patients (three men and two women), with meningiomas of extracranial origin or meningiomas of intracranial origin, spreading into the head-and-neck region. All patients were surgically treated, with the addition of adjuvant radiation therapy in some of the cases. Postoperative and postirradiation complications were described as well.
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Intestinal obstruction secondary to cecal endometriosis
p. 1081
DE Imasogie, PI Agbonrofo, MI Momoh, DE Obaseki, I Obahiagbon, AT Azeke
DOI
:10.4103/njcp.njcp_29_18
PMID
:30074015
Endometriosis of the gastrointestinal tract is rare and occurs in <1% of all patients undergoing major gynecological surgeries. Bowel involvement has been reported in 3%–37% of all women of childbearing age with endometriosis. Total obstruction of the gastrointestinal tract occurs in <1% of cases of endometriosis with bowel obstruction. This case report is that of a 42-year-old female who presented with a 6-month history of change in bowel habits in favor of increasing constipation. This was associated with cyclical lower abdominal pains, abdominal swelling, and weight loss. Examination revealed hyperactive bowel sounds with scant fecal matter on rectal examination. An impression of intestinal obstruction was made and she had an emergency laparotomy. Dilated ileum and a hard, constricting cecal mass were found intraoperatively. She had a right hemicolectomy and ileo-transverse anastomosis, with progressive improvement postoperatively. Histology of the resected bowel segment confirmed cecal endometriosis. In conclusion, cecal endometriosis is a rare cause of intestinal obstruction. A high index of suspicion is required for diagnosis, especially if the woman is premenopausal with a history of abdominal pain that worsens with menstrual periods. Outcome is good with appropriate surgical intervention.
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© Nigerian Journal of Clinical Practice | Published by Wolters Kluwer -
Medknow
Online since 10
th
November, 2010