We aimed to assess the complications of minimally invasive balloon-assisted maxillary sinus floor augmentation, compared with the conventional sinus floor augmentation procedures done before placing a dental implant. A structured question was formulated and an electronic search was conducted in three databases (MEDLINE via PubMed, Google Scholar, and Scopus). A separate search of gray literature and a hand search for missing articles were also conducted. Apart from animal studies, in-vitro studies, and case reports, all other types of studies where maxillary sinus floor augmentation was done using a balloon were considered for review. Our review was registered in International Prospective Registration of Systematic Reviews (PROSPERO) under number CRD42018086770. Our search produced 73 articles. However, only eight articles were found eligible to be included in our review (seven case series and one case-control study). Quality check was done using Methodological Index for Non-Randomized Studies (MINORS). Results suggest that balloon-assisted augmentation is associated with low rates of membrane tears (9 out of 272 sinus augmentation attempts), and high follow-up bone gain levels (mean 212.91%, 95% confidence interval 158.07%–267.75%, I2 = 97.62%). Balloon-assisted augmentation seems to be safe. More clinical trials are needed to assess the advantages and disadvantages of balloon-assisted maxillary sinus floor augmentation compared with other procedures.

Aims: The aim of this study was to determine the best approach to reduce the unfavorable change in the three different dimensions of impressions using disinfection durations of 15 and 30 min; three different disinfection procedures; and alginate impression products as research factors. Materials and Methods: CA37, impressional, and cream alginate impressions were used; distortion in the AB, AC, and BC dimensions of impressions using disinfection durations of 15 and 30 min was studied; and no disinfection (ND), conventional disinfection (CD), and sonicator-activated disinfection (SAD) procedures were measured. Results: Regarding AB dimension, the impressional has best performance when CD was applied for both 15 and 30 min. When SAD was applied for 15 min, impressional and cream alginates provide best performance. When CD was applied for 15 min, CA37 and impressional alginates provide best performance. Although ND-applied CA37 alginate after 30 min provides best performance, because of many outlier values, its implication may not be considered as meaningful. Regarding AC dimension, cream alginate has best performance when CD was applied for 15 min. The AC distances in all the alginates are considerably different from the base model after 30 min. Regarding BC dimension, only the CA37 alginate has the best performance when ND was applied for 15 min. All the alginates are considerably different from that of the base model after 30 min. Conclusion: Preference of 15-min disinfection can provide favorable results to obtain all impressions with minimally distorted dimensions. CD is an adequate procedure. The studied SAD needs to be developed further. All alginates are comparably successful to obtain impressions with desired distortion degrees.

Aims: To evaluate the presence of dentofacial asymmetry in patients with odontoma by panoramic radiography. Methods: Panoramic images with odontoma were selected among all panoramic radiographs (3058 patients). Maxillary odontoma was detected in 27 patients while mandibular odontoma was detected in 25 patients. In addition, 30 patients with similar age and gender characteristics were selected as the control group. Skeletal angular, skeletal linear and dental measurements were performed on panoramic radiographs. The odontoma region and the opposite side of the odontoma of the individuals were examined. The dentofacial asymmetry of the odontoma groups was compared with the control group. Paired t-test was used to determine dentofacial asymmetry on the right and left side of the patients with odontoma. The ANOVA test was used for testing the differences among groups. Results: As a result of study, no significant difference was found between the region of the odontoma and the symmetrical region in the maxilla and mandibula (P > 0.05). In the control group, a statistically significant difference was found in the angle between the mandibular canal and the mental foramen, lower incisor size, PFH/CutCat(°), and Co-Mc-Me(°) measurements (P < 0.05). In the maxillary and mandibular odontoma groups, a statistically significant difference was found in the angle between the mandibular canal and the menton, CH (mm), RH (mm), and CrH (mm) in the comparison of the odontoma and the control group (P < 0.05). Conclusions: No difference was found between the right and left sides of the jaws related with the asymmetry of the maxilla and mandible.

Background: Diabetes mellitus is one of the most widely spread systemic diseases worldwide. It is characterized by hyperglycemic status with major multiorgan impact. With regard to the oral cavity, the relationship between diabetes mellitus and periodontal disease is well-known, although other dental diseases have been neglected. Aims: The aim of this study was to assess the characteristics of type 2 diabetes mellitus patients and correlate it with the inflammation of the marginal and apical periodontium and the status of the underlying disease. Subjects and Methods: The current prospective study analyzed 128 patients with type 2 diabetes mellitus, in terms of marginal as well as apical periodontal involvement. The patients presented voluntarily for evaluation and treatment of oral diseases and their oral health status was established based on clinical and imaging examinations. Biological samples were collected when necessary to determine mycotic diseases. The clinical characteristics of each patient were recorded in a study sheet, and the data were centralized in electronic format using Microsoft Excel. The statistical values of the assessed cases were calculated with a two decimal accuracy, using the Chi-Square, Mann–Whitney and Student t tests. Results: The results obtained evidenced an incidence of apical periodontal infection of approximately 50%, with a slightly higher value for patients with decompensated diabetes mellitus compared to those with compensated diabetes mellitus. Conclusions: The results obtained show a higher incidence of apical periodontal infections, regardless of the compensation level of type 2 diabetes mellitus.

Background: Denture hygiene is an important factor to remove dental plaque and discoloration, to provide optimal oral health, and to prevent denture stomatitis. Aim: The purpose of this study was to evaluate the effect of coffee staining and denture cleaner on the color stability of two differently polymerized (heat and microwave) denture acrylic resin in vitro. Materials and Methods: Two commonly used denture base acrylic resins and effervesecnt tablet form denture cleaner were used in this study. Disc-shaped specimens from each acrylic resin were polymerized according to the manufacturer's instructions (n = 7). Color values were recorded before and after immersion in distilled water (I), denture cleaner (II), coffee (III), and coffee + denture cleaner (IV) with a tristimulus colorimeter using CIEDE2000 color difference formula. Two-way analysis of variance (ANOVA) and Fisher's least significant difference tests were used for multiple comparisons at a 95% confidence level (P < 0.05). Surface topography of the acrylic resin denture base specimens before and after immersion were taken under 500 × magnification. Results: The two-way ANOVA revealed significant interactions between denture base resins and solutions (P < 0.001). Immersion in denture cleaner and coffee solution caused significant color changes in acrylic resin denture bases. Conclusion: Heat- and microwave-polymerized acrylic denture base resins can show different color stability. Immersion in coffee and denture cleaner solutions can cause noticeable color changes.

Background: The abdominal aorta is the largest artery in the human body. Sonographic assessment of the abdominal aortic diameter is presently the preferred screening method for an aortic aneurysm. However, there are no customized nomograms for our population and the recommended cutoffs for screening may be inappropriate. The effect of factors such as age, gender, and body mass index (BMI) on the abdominal aortic dissection (AAD) among blacks has also not been extensively investigated. Objective: To develop a nomogram of AAD at various levels in Nigerian adults using high-resolution B mode ultrasonography and to evaluate the effect of factors such as gender, age, and BMI on AAD. Methodology: This study involved a sonographic evaluation of the abdominal aortic diameter of 400 normal Nigerian adults aged 18 years and above over a period of 17 months. The scan was done using a 3.5–5 MHz curvilinear transducer on the Mindray ultrasound machine (model: DC-8, SN-QE3B001806). The AAD (mean ± SD) was correlated with age, gender, BMI, and body surface area (BSA). Data were analyzed using SPSS version 20 for windows and P values <0.05 were considered significant. Results: The mean AADs decreased from 1.58 ± 0.24 cm in the upper aorta (D1) to 1.40 ± 0.20 cm at the level of the renal arteries (D2) and 1.29 ± 0.23 cm at the bifurcation (D3). Mean AAD was significantly higher at all levels of the abdominal aorta (D1, D2, and D3) in males than in females (P < 0.00) and correlated positively with age (P = 0.00) and height (P = 0.00) at D2 and D3 levels. Conclusion: Absolute AADs were relatively smaller in adult Nigerians and this should be considered when setting up screening programs for abdominal aortic aneurysm in our population. Further studies are needed to determine factors affecting AAD.

Objective: To explore the factors associated with depression and anxiety among glaucoma patients. Subjects and Methods: This was a cross-sectional study involving adult glaucoma patients, who attended the eye clinic of Enugu State University Teaching Hospital, Parklane, Enugu, from April to September 2018. In total, 182 glaucoma patients with no other significant ophthalmic or medical conditions were recruited. Information on their socio-demographic and clinical characteristics was obtained using a close-ended, interviewer-administered questionnaire. Detailed ophthalmic evaluation to characterize the glaucoma was done. Depression and anxiety were assessed using the hospital anxiety and depression scale. Data were analyzed using SPSS version 21. Bivariate analysis was done to identify factors associated with depression and anxiety. The level of significance was at P < 0.05. Results: The participants were mainly females, 108 (59.3%), married, civil servants with tertiary education and mean age of 59.7 ± 13.3 SD years. Majority of them had advanced stage of primary open angle glaucoma. Eighty (44%) of the participants had anxiety, while 76 (41.8%) had depression. Severe/blind stage of glaucoma and reduced visual acuity were significantly associated with anxiety and depression; occupation (trading) and intraocular pressure of <21 mmHg also significantly associated with depression. Conclusion: The prevalence of anxiety and depression among glaucoma patients in Enugu was high. Severe/blind stage of glaucoma and reduced visual acuity were the most important factors that associated with both anxiety and depression. Incorporating a psychological health approach to glaucoma care especially in patients with severe glaucoma and reduced visual acuity may promote effective communication between clinicians and patients and treatment adherence.

Objective: The aim of this in-vitro study was to investigate the effects of frequently consumed beverages on the color stability and microhardness of various restorative materials. Materials and Methods: Twenty-four samples were prepared in each group to examine the effect of different beverages on coloration and surface hardness of two direct composite resins (Filtek Z250, Filtek Z550); one indirect composite resin (Solidex); and one high viscosity glass ionomer cement (Equia Forte Fil). Samples were stored in four solutions (distilled water, black tea, coffee, and cola) at room temperature for 1 week (n = 6). The color values are taken at the beginning and the color and microhardness values taken at the end of 1 week were evaluated by the Kruskal–Wallis and Mann–Whitney U tests. Results: The highest color change was observed in the Equia Fil, while the least color change was observed in the Z550 group. The highest degree of color change was observed in coffee and cola groups. While the lowest values of hardness were observed in the Solidex group, the highest values of hardness were observed in the Z550 group. The highest levels of hardness change were detected in the coffee and cola groups. Conclusion: The color and hardness of restorative materials can be negatively affected by consumed beverages. Nanohybrid composite resins are resistant to external coloration and hardness change.

Objectives: The aim of this study is to determine the type, frequency, and location of incidental findings in the maxillofacial region in patients undergoing cone beam computed tomography (CBCT) scan for implant treatment.^[5]Methods: In this study, 300 patients who underwent CBCT imaging for implant treatment planning were evaluated retrospectively. Patients were evaluated in four different categories, namely, maxillary sinus pathologies, temporomandibular joint (TMJ) findings, dentoalveolar findings, and soft-tissue calcifications. In maxillary sinus pathologies, we categorized patients by mucosal thickening, polypoidal lesion, air–liquid level, total opacification, oroantral fistula, periapical lesion related with maxillary sinus, antrolith, hypoplasia, and foreign body presence. In the TMJ findings category, we evaluated patients for erosion, osteophyte, sclerosis, flattening, and bifid condyle. For dentoalveolar findings, we looked for the residual root and impacted tooth. In soft-tissue calcifications, we examined patients for tonsillolith, sialolith, lymph node calcification, styloid ligament calcification, carotid artery calcifications, and osteoma cutis. Results: Mucosal thickening was mostly seen in maxillary sinus pathology. One hundred and forty-eight (49.3%) of the patients had at least one TMJ incidental finding. We detected at least one impacted tooth in 17 (5.7%) patients' maxilla and 14 (4.7%) patients' mandibles. The most frequently seen calcification was styloid ligament calcification. There was no statistically significant relationship between the age groups and incidental findings (P > 0.05). Conclusions: Oral radiologists should be aware of incidental findings and evaluate the possibilities of underlying diseases in a comprehensive way, and if there is a concern about the finding, they should refer the patient to the relevant specialist.

Aim: To present the anatomical and visual outcome and compare different techniques in the surgical treatment of proliferative vitreoretinopathy (PVR) in Nigerians.Method: Comparative retrospective review of PVR grade C and D eyes that had vitreoretinal surgery with silicone oil between April 2005 and December 2012. Data was extracted from consecutive case notes after exclusion of eyes with PVR associated with proliferative diabetic retinopathy (PDR), proliferative sickle cell retinopathy (PSCR) and eyes with nonuse of silicone oil. A comparison of the outcome of vitrectomy alone (Vit.), versus combined with a scleral buckle (Vit.+SB), versus with retinectomy (Vit.+RT), versus with all three procedures (Vit.+SB+RT) was done. Statistical analysis was done using the Statistical Package for Social Sciences version 16 software. Pearson Chi-square test and Fisher's exact T-test were used to determine the effect of relationships. Results: 138 eyes of 138 patients had grades C (100 eyes) and grade D (38 eyes) PVR. Surgery involved vitrectomy and membrane peel in 53% of eyes, additional scleral buckle in 22%, and retinectomy was performed in 17%. Retinal reattachment rate was 86% for PVR C eyes and 87% in PVR D eyes. There was no statistically significant difference in anatomical outcome between vitrectomy alone and the combination surgeries. In the vitrectomy only category, the postoperative vision was noted to improve (> preoperative), in 48% of PVR C and in 31% of PVR D. 33% of PVR C and 44% of PVR D eyes had a worse vision (< preoperative). Visual outcome was similarly poor in the combination surgeries with improved vision noted in 12%, 44%, and 33% of the Vit.+SB, Vit. +RT, and Vit.+SB+RT PVR C eyes, respectively. In PVR D eyes, improved vision was seen in 57% and 12% of Vit.+SB and Vit.+RT eyes, respectively. Conclusion: Surgery results in anatomical reattachment and there is nonsuperiority of any technique. Visual outcome is poor as previously reported. Recent trials of pharmacological adjuncts may show promise for improved visual outcomes.

Background: Dental trauma is a major public oral health problem owing to its high prevalence. The school sports teachers who observe children when they participate in sports have a key role in the prevention and management of traumatic injuries. The present study aims to determine the awareness of sports teachers on the occurrence and prevention of oral-facial trauma in southern Saudi Arabia. Methods: The present study was a cross-sectional study design among sports teachers in a southern subpopulation of Saudi Arabia. A draft questionnaire with 11 items was constructed under three domains: occurrence pattern, prevention, and management of dental trauma. Results: A total of 191 sports teachers from various schools participated in the survey. The majority (88%) of the teachers had encountered orofacial trauma among children during sporting activity in schools. The most common orofacial structure involved in injury was the teeth (33.5%) and lips (25.2%). Only 50.8% of subjects knew stock tray as a type of mouthguard and 27.7% of teachers responded that they do not recommend mouthguards for children during sporting activities. Nearly 80.6% teachers were aware of the possibility of reimplanting an avulsed tooth. About 72.8% teachers had poor knowledge of immediate action necessary for successful outcomes of reimplanted teeth. Conclusions: Orofacial trauma was commonly encountered by sports teachers among children during sporting activities in the school. There was poor awareness regarding types of mouth guards and its significance among the sports school teachers. The knowledge related to the management of emergency oral injuries was inadequate.

Objective: To evaluate and compare the fracture resistance and marginal adaptation of Zirconomer and bulk fill posterior restorative material (Surefil SDR) in nonendodontically and endodontically treated teeth. Materials and Methods: The sample consisted of 52 caries-free extracted human premolars which were individually mounted in polyvinyl chloride (PVC) ring filled with acrylic resin up to 1.0 mm below the cementoenamel junction. The teeth were then divided into four groups according to the restorative material used as group I: Zirconomer + Operative only, Group II: Zirconomer + Endodontic treatment, Group III: SDR + Operative, and Group IV: SDR + Endodontic treatment. Fracture strength was tested using a universal testing machine and was expressed in Newtons. The marginal gap was measured at its maximum using a scanning electron microscope and expressed in micrometers. One-way analysis of variance followed by Tukey's post hoc test was used to compare the mean fracture resistance (N) and marginal adaptation (μm) between the four groups. Statistical significance was determined at α = 0.05. Results: Group 3 exhibited significantly highest mean fracture resistance than Group 1 (P < 0.001), Group 2 (P < 0.001), and Group 4 (P < 0.001). Group 4 had significantly higher mean fracture resistance than Group 1 (P = 0.008) and Group 2 (P < 0.001). Group 1 exhibited significantly highest mean marginal gap than Group 3 (P < 0.001) and Group 4 (P < 0.001). Group 2 had a significantly higher mean marginal gap than Group 3 (P < 0.001) and Group 4 (P < 0.001). Conclusion: The fracture resistance and marginal adaptation of Zirconomer are significantly lower than Surefil SDR in both nonendodontically and endodontically treated teeth.

Objectives: This study evaluated the effect of Er, Cr: YSGG laser irradiation at different powers on repair bond strength (RBS) between ceramic restoration and composite resin (CR). Materials and Methods: Sixty ceramic samples were prepared and thermocycled for 2,500 cycles between 5°C and 55°C. Samples randomly divided into six groups (n = 10) according to the different surface treatment: control group (no surface treatment), 9.6% hydrofluoric acid etching, 37% phosphoric acid etching, and irradiations with Er, Cr: YSGG lasers (1 to 3W). The Cimara System was applied to all samples surface according to the manufacturer's instructions. CR resin was built-up on each ceramic surface using a tygon tube. The RBS test was performed at a crosshead speed of 1 mm/min, and one sample of each group was also observed under SEM and EDS was used to measure the elemental profiles of each specimen. Data was analyzed with one-way ANOVA and Tukey HSD test. Results: The lowest RBS was recorded in Group OF, and the highest RBS was recorded in Group HF, followed by Group 3W. There was no statistical difference between Group Control, 1W and 2W. Furthermore, differences in RBSs between Group 3W and the other groups except Group 2W were significant (P < 0.05). In EDS analysis, there are evident differences between surface treated samples and controls. Conclusions: 3W laser irradiation may be an alternative method to acid etching for enhancing the RBS of CR to ceramic.

Background: Birth preparedness and complication readiness (BPCR) reduces delays in obstetric care, improves health-seeking behavior during an obstetric emergency, and improves knowledge on danger signs of pregnancy. Aims: To assess the knowledge, perception, and practice of women on BPCR. Subjects and Methods: This was a cross-sectional study conducted at Federal Teaching Hospital in Ebonyi state, Nigeria at the postnatal ward from June to December 2016. Women who delivered were recruited consecutively on discharge from the postnatal ward. Their knowledge, perception, and practice of BPCR in the last pregnancy were sought. Information obtained were analyzed using 2008 Epi-info™ software version 3.5.1 (Atlanta Georgia USA). Result: A total of 438 of 445 questionnaires were correctly filled and analyzed giving a response rate of 98.4%. Most of the women knew about birth preparedness 384 (87.7%) and complication readiness 348 (79.5%). A significant number of women did not access antenatal care within the first trimester 236 (53.9%), did not know that family planning is important in BPCR 216 (49.3%), and did not identify means of transport in the event of emergency 354 (80.8%). No provision of blood during antenatal care for the blood banking system was a common finding 258 (58.9%). In multivariate logistic regression analysis, choosing a health care provider was a common finding among literate mothers (OR = 2.8,95% CI = 1.02,7.72), woman within 25–29 years (OR = 1.09, 95%CI = 1.02,1.16), and multiparas (OR = 0.82, 95% CI = 0.67,0.99). Conclusion: There is increased knowledge and awareness of BPCR but the comprehensive components and practices of BPCR are still not optimal in our setting.

Background: Job satisfaction of health workers is essential in building up employee motivation and efficiency. The objective of this study is to ascertain the level of job satisfaction among health professionals in a federal tertiary health institution in Nigeria. Methodology: This study was done at the National Orthopedic Hospital, Enugu (NOHE), in south-east Nigeria. Two hundred and thirty-six health workers were recruited from the various clinical departments via a systematic sampling technique. A questionnaire documenting relevant sociodemographic data and assessing the level of satisfaction with the financial remunerations, working conditions, infrastructure and equipment, learning and academic sponsorships, welfare packages, and performance appraisal systems was administered to them. Results: The findings revealed a relatively low level of job satisfaction among the staff of NOHE especially with regards to financial remuneration, working conditions, tools and infrastructure, learning and training opportunities/sponsorship, leadership style, and welfare packages with increasing dissatisfaction in that order. However, the average staff is satisfied with the performance appraisal system as regards promotion. Conclusion: The majority of the clinical staff have a low level of job satisfaction. A review of the salary structure of health professionals as well as improving the working conditions, tools, and infrastructures in the hospital is needed.

Background: There are important criteria in the diagnosis of temporomandibular disorders (TMDs). These become significant if supported by magnetic resonance imaging (MRI). Otherwise, these findings alone may not be sufficient to diagnose TMD. Aim: This study compared the relationship between clinical findings indicated by patient and physician and MRI results in the diagnosis of TMD. Materials and Methods: Clinical examinations were performed in patients suspected of TMD for pain, difficulty in mouth opening, masticatory muscle tenderness, deviation (during mouth opening), normal mouth opening, and presence of bruxism. The MRI findings of the patients were compared with the clinical examinations. Results: MRI and clinical examination data of 136 patients were examined. The results showed significant correlations between deviation, normal mouth opening, and MRI results of TMD (P < 0.05). No correlation was found between age groups and clinical findings of TMD. TMJ was determined in normal limits in 61% of MRI results. Conclusions: Except for deviation and normal mouth opening, complaints and clinical findings determined by the clinicians do not support TMD. This may be due to the subjective nature of the clinical findings, and MRI results are needed for precise results.

Objectives: This study aimed to compare the effect of different solutions on the removal of orange-brown precipitate with or without ultrasonic activation. Materials and Methods: One hundred and twenty extracted maxillary anterior teeth were instrumented. In experimental groups (n = 10), canals were flushed with 17% EDTA, 10% citric acid, 1% phytic acid, 96% alcohol and distilled water either using syringe irrigation or ultrasonic activation, after creating orange-brown precipitate. Teeth were sectioned longitudinally and subjected to stereomicroscopic analysis. The amount of precipitate was scored and the data were analyzed (P = 0.05). Results: There were no differences detected among the tested solutions (P > 0.05). There was a significant difference between ultrasonically activated irrigation and syringe irrigation for EDTA and distilled water in coronal, middle portions (P < 0.05). Conclusions: Ultrasonic activation significantly improved the precipitate removal capacity of EDTA and DW. Tested solutions were similarly effective regarding the removal of the precipitate.

Objective: Piperlongumine (PL) is an alkaloid derived from the edible pepper (Piper longum L) and it has been described to have various biologic activities including anticancer effects. Our aim in this study was to assess the cytotoxic role of PL on a cervical cancer cell line (HeLa) and to evaluate the effects of PL/doxorubicin and PL/paclitaxel combination therapies on apoptotic cancer cell death. Material and Methods: The cytotoxicity, IC50 doses by MTT assay confirmed by fluorescent imaging, and apoptotic cell rates by Annexin V staining using flow cytometry were determined for PL, doxorubicin, paclitaxel, and for their combinations. Results: It was shown that the PL by itself induced the apoptosis in HeLa cells. PL in combination with doxorubicin and paclitaxel increased apoptotic cell death compared to either chemotherapeutic agent alone. Conclusion: We conclude that the PL inhibits cancer cell growth by inducing apoptosis and has a potential anticancer activity in cervical cancer, especially when combined with doxorubicin and paclitaxel.

Background: Tooth agenesis is the congenital lack of one or more primary or permanent teeth and it is the most frequently seen dental anomaly. The prevalence of third molar agenesis is significantly higher than the agenesis of other teeth varying from 10% to 40% and shows geographical variance. Aims: The aim of this study was to investigate the prevalence of third molar agenesis and its association with other tooth agenesis of jaws. Subjects and Methods: A total of 594 Turkish subjects with or without agenesis of third molars (M3) were included in the study. Dental records and panoramic radiographs were evaluated for M3 agenesis, hypodontia and hyperdontia. Significant differences in the prevalence rate of M3 agenesis between genders among with evaluation of coexistence of M3 and other tooth agenesis were determined by Fisher's exact test. Results: The prevalence of M3 agenesis was determined as 28.7% with no statistically significant gender or location difference. Most common form of M3 agenesis involved one molar followed by two, four and three molars. Agenesis of other teeth was seen among both patient groups with and without M3 agenesis, without significant difference. Conclusions: Turkish population with M3 agenesis did not show increased prevalence of other tooth agenesis, indicating no association between occurrence of agenesis of other teeth and M3.

Background: Treatment satisfaction and medication adherence to oral anticoagulant therapy are important measures that often decrease morbidity and mortality. Though warfarin is a frequently prescribed oral anticoagulant, warfarin therapy adherence (WTA) and its impact on overall Health-Related Quality of Life (HRQoL) has not been studied in Saudi Arabia. Objectives: To assess the association between WTA and HRQoL among patients on warfarin in Saudi Arabia. Methods: A prospective, cross-sectional, descriptive study was conducted on 387 patients on warfarin therapy attending an outpatient anticoagulation clinic in Alkharj, Saudi Arabia. WTA was assessed using medication adherence measuring scale (MAMS) whereas HRQoL was measured using World Health Organization QOL-BREF (WHOQOL-BREF). Descriptive and inferential statistics were used to examine patients' demographic characteristics and to determine the association among different variables. Spearman's correlation coefficient was used to determine the association between various study variables. Results: Of the total 387 participants, there were more females than males (n=257, 66.4%, and n=130, 33.6% respectively). The mean adherence score for the study population was 5.86±1.21. Mean HRQoL score for physical health domain, psychological domain, social relationships domain, and environment domain were 62.11±15.53, 68.20±16.11, 64.46±26.19 and 63.43±17.60 respectively. The correlation coefficients for all the four domains of the WHOQOL-BREF vs total mean score of warfarin therapy adherence were 0.124, 0.051, 0.063 and 0.083 respectively indicating a weak positive association between warfarin therapy adherence and physical health domain (P < 0.005). Study results indicate a positive association between WTA and the physical health domain of the WHOQOL-BREF among patients on warfarin. Conclusion: Better warfarin therapy adherence can improve the physical health of patients on warfarin.

Background: Genital infections are one of the most common reasons for a hospital visit in the scope of reproductive health problems. The information-motivation-behavioral skills (IMB), therefore, is an appropriate model to provide women with accurate genital hygiene behaviors and develop effective sexual and reproductive health training programs. Aims: This interventional study was conducted to assess the effectiveness of genital infection awareness training provided to women based on the IMB model. Materials and Methods: Study sample consisted of 62 women (n_experimental= 31, n_control= 31) who were chosen based on a nonprobability sampling method from vocational courses of Ankara Keçiören municipality. The data collection form developed by the researchers, knowledge evaluation questions (KEQ), and genital hygiene behavior inventory (GHBI) were used to collect data. Data were obtained at training centers and through phone interviews. Another interview was conducted 1 month later and posttest procedures were completed. The Chi-square test, McNemar's, Mann-Whitney U test, and Wilcoxon Signed-Rank tests were used to calculate mean scores. Results: The mean (SD) age was 39.1 (8.4) years for the women in the experimental group and 37.5 (6.7) for the women in the control group (P = 0.481). Pretest knowledge mean scores M (SD)_experimental = 15.7 (2.4); and GHBI mean scores M (SD)_experimental= 76.9 (11.1) were calculated. Mean scores showed an increase after the training in the experimental group [M (SD)_post-test= 19.1 (1.2); M (SD)_GHBI= 94.7 (2.6)] (P < 0.001). Conclusion: Based on these findings, it was concluded that the genital infection awareness training provided to women based on the IMB model, improved knowledge and acted as a positive reinforcer for the hygiene behaviors of the women.

Background: To evaluate the quality of life in pregnancy is very important because of the changes in the female body during pregnancy. Quality of life should be evaluated in terms of health protection during pregnancy, prevention of health problems and treatment. Aims: The aim of this study is to determine the quality of life and the affecting factors by trimesters of pregnancy. Methods: The population of this cross-sectional study consisted of pregnant women in a city center of the Central Anatolia region of Turkey. The study included 12 districts across a range of socioeconomic structures. Every district was selected by a simple random sampling method. The study was conducted by the researchers in the home of pregnant women by face to face interview method. The data were collected using “Personal Information Form” and “Quality of Life Scale”. The total sample consisted of 1010 pregnant women, 192 of which were in first trimester, 277 of which were in second trimester and 541 of which were in third trimester. Data were analyzed using Statistical Package for Social Sciences (SPSS). Results: There was no statistically significant difference between trimesters in physical domain (P = 0.96), mental domain (P = 0.94) and social domain (P = 0.47) of quality of life scale and there was a difference only in environmental domain (P = 0.02). The lowest quality of life in all three trimesters was found to be in physical domain. Conclusion: There was no statistically significant difference between trimesters in physical, mental and social domains of quality of life scale and there was a difference only in environmental domain. The lowest quality of life scores in all three trimesters were in the physical domain. The quality of life of pregnant women differed according to the trimesters and some sub-dimensions of quality of life of pregnant women were negatively affected in all three timester.

Congenital agenesis of lateral incisor is one of the most prevalent dental anomalies and is commonly treated by correcting the axes of maxillary central and canine teeth deviated toward the deficient area orthodontically, replacing the missing maxillary lateral incisor with dental implants and prosthetic restorations. Conducting treatment in interdisciplinary manner is the main criterion for the successful outcome. If this is ignored, clinicians may experience biological, mechanical or combined complications. As encountered in this case, bone resorption may occur if there is very limited bone-width or if there is a past of orthodontic treatment. In contemporary dentistry, this biological complication can be treated with the aid of a mixture including bovine bone graft material and advanced platelet-rich fibrin.

Bleeding oesophageal varices is a rare condition in children and most of them are usually of extrahepatic causes. Neonatal umbilical catheterization even though safe has been identified as a cause of portal vein thrombosis and oesophaeal varices. We report a 9-year old Nigerian girl who had massive upper gastrointestinal bleeding from oesophageal varices secondary to pulmonary vein stenosis. She had umbilical catheterization for exchange blood transfusion as a neonate. She was sequentially managed with endoscopic sclerotherapy and band ligation We seek to highlight the need for a high index of suspicion of oesophageal varices in children with upper gastrointestinal bleeding who had neonatal umbilical catheterization.

In today's dentistry, with the development of adhesive techniques and the improvement of resin-based materials, invasive restorative treatments have been replaced by minimally invasive or noninvasive restorative procedures. Fiber-reinforced adhesive bridges are minimal-invasive or noninvasive restorations that can be applied for definitive restoration in single tooth loss or short spans, where teeth or implant-supported fixed partial prosthesis cannot be applied. This case series describes the rehabilitation of three patients with anterior single tooth loss using the direct fiber-reinforced adhesive bridge. In all patients, esthetic and functional deficiencies in the missing tooth regions were solved with this minimally invasive technique, which is both cost-effective and conservative of tooth structures. During the three-year follow-up of these cases, there was neither fracture nor decementation in the restorations. Also, no caries or sensitivity was noted in the support teeth.