Obstetric fistula is a serious public health problem affecting women in low- and middle-income countries. It is characterized by continuous leakage of urine and/or feces from the vagina as a result of injuries sustained from childbirth. It has continued to exist in Nigeria because the publicly funded health-care system has failed to provide quality, equitable, accessible, and affordable maternal health care. It is largely a problem of poor, young, uneducated, and rural women who lack access to quality maternity care. Universal health coverage implies a system which provides quality health-care and financial protection to all citizens of a country. This is attained when all citizens have the needed health services without being subjected to out-of-pocket expenditure. Universal health coverage is currently not obtainable in Nigeria. When implemented, it will eliminate the existing inequality in access to health care, thereby allowing the poor and vulnerable citizens access to quality maternity care and safe delivery. A comprehensive health insurance cover for all pregnant women regardless of socioeconomic status, priority setting in resource allocation, and public–private partnership are advocated for eradication of obstetric fistula in Nigeria.

The National Surgical Obstetric and Anaesthesia Plan is an invaluable country resource with the capacity to promote increased access to safe and affordable surgical and anaesthesia care if implemented. Although cost of implementation is only a fraction of Health Sector Strategic Plan cost in the countries with costed plans, it is important that the funding of the plans is based on sustainable financing strategies. This will ensure appropriate and timely implementation and sustainability of the plan itself. The aim of this review was to discuss and make recommendations on innovative and sustainable strategies for financing national surgical plans in sub-Saharan Africa.

Background: Timing of laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) is still debated. Aims: The aim of this study was to investigate the effect of timing on operative results; from the first appearance of symptoms to the operation. Methods: The study included 57 sequential patients operated laparoscopically for AC. Patients operated within the first 3 days of admission (Group 1), those operated between 4^th and 7^th days (Group 2) and those operated after 7^th day (Group 3) were evaluated and compared with respect to demographics, time from admission to operation, duration of operation, adhesion score, complications, conversion rates, duration of hospital stay, morbidity and mortality rates, bile culture results, and histopathological evaluation. Results: A total of 63% of the patients were female and 21 (37%) were male. The mean age was 48 years (range, 21–74). There was no significant difference among the groups with respect to demographics (P > 0.05, for each). The duration of operation was significantly shorter in Group 1 than both Groups 2 and 3 (P < 0.05 and P < 0.001, respectively). Duration of operation was also significantly shorter in Group 2 than Group 3 (P < 0.001). Group 1 had significantly fewer adhesions compared to Group 2 and Group 3 (P < 0.05 and P < 0.001, respectively), and no significant difference was found between Group 2 and Group 3 (P > 0.05). Duration of hospital stay was significantly shorter in Group 1 compared to Group 2 and Group 3 (P < 0.001) and also was significantly shorter in Group 2 than Group 3 (P < 0.05). Group 1 had significantly lower rate of culture proliferation than Group 3 (P < 0.001), whereas no significant differences were evident in other inter-group analyses (P > 0.05, for each). Conclusion: LC can safely be performed within 7 days of admission in cases of AC.

Aims: This study aimed to assess parents' awareness and attitude regarding their children's malocclusion compared with professional assessments and to measure the prevalence of malocclusion among children in Dammam, Saudi Arabia. Methods: The study population consisted of 377 randomly selected children (aged 8–12 years) from five schools in Dammam, Saudi Arabia. A questionnaire was used to assess parents' awareness using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and knowledge about preventive orthodontics. A clinical examination was performed by two calibrated examiners to measure the prevalence of malocclusion using both the AC and dental health component (DHC) of IOTN. Results: The most common Angle's molar relationship was Class I (78.2%), followed by Class II (17.5%) and Class III (4.2%). The DHC (score 3–5), which indicated the need for orthodontic treatment, was 55.4%. There was a significant difference (P < 0.05) between AC from examiners and parents, whereby the parents tended to underestimate their children's malocclusion by a factor of 1.45. Surprisingly, many parents (67.4%) lacked knowledge about preventive orthodontics. Conclusions: Class I malocclusion was most prevalent among children in the area of Dammam. A moderate percentage (55.4%) of the study subjects required treatment based on the DHC. Based on the lack of knowledge about preventive orthodontics in the majority of parents in our study, it is recommended that oral health-promoting programs be implemented to improve the awareness of malocclusion in the region.

Background: Reproductive hormones and reactive oxygen species produced by either hormonal or aerobic metabolism have been implicated in carcinogenesis of the breast and disease progression. Perturbations in the homeostasis of female reproductive hormones and oxidative stress indices in breast cancer (BCa) could be used for monitoring disease prognosis. Objectives: The aim of this study was to assess levels of some biomarkers of oxidative stress and female reproductive hormones in postmenopausal women with BCa at different stages. Methods: Reduced glutathione (GSH), total antioxidant capacity (TAC), total plasma peroxides (TPP), nitric oxide (NO), malondialdehyde (MDA), estradiol (E₂), and prolactin (PRL) levels were determined in 50 post-menopausal women with BCa (stages II–IV) and 50 women without BCa (controls) by colorimetry and ELISA methods. Oxidative stress and body mass indices (OSI &BMI) and clinical history were obtained. Results: Post-menopausal women with BCa had significantly higher BMI (26.60 ± 5.17 vs 22.73 ± 1.21 kg/m², P=<0.001), TAC (5.59 ± 2.38 vs 4.43 ± 2.66 mmol/l, P = 0.023), TPP (4.92 ± 3.59 vs 2.98 ± 2.82 mmol/l, P = 0.003), NO (31.96 ± 10.73 vs 23.92 ± 6.37 μmol/l, P=<0.001) and E₂ (78.89 ± 54.54 vs 11.08 ± 14.80 pg/ml, P = 0.003) levels and lower mean age at menarche (13.16 ± 0.87 vs 14.14 ± 1.60 years, P=<0.001) compared to controls. Controls had significantly lower E₂ (P = 0.003), TPP (P = 0.005) and OSI (P = 0.043) compared to women with stage II BCa; lower E₂ (P=<0.001), NO (P = 0.010), TAC (P = 0.010) and TPP (P=<0.001) compared to stage III BCa; and lower E₂, (P=<0.001), NO (P = 0.044) and MDA (P = 0.020) compared to stage IV BCa respectively. Prolactin correlated positively with E₂ (r = 0.296, P = 0.037), and TAC (r = 0.336, P = 0.011) in women with BCa. Conclusion: Postmenopausal women with BCa at different stages have increased estradiol, antioxidants, lipid peroxidation, and oxidative stress index suggesting that these indices may be useful for clinical assessment and monitoring progression of breast cancer.

Background: The success of noninvasive ventilation (NIV) treatment is closely related to high levels of clinical support. Aims: In this study, we sought to analyze patient mask compliance and minor side effects and to evaluate additional nursing workload needed for the NIV care. Materials and Methods: The study was designed as a prospective and observational. The data were collected from an intensive care unit. Clinical and physiological data, patient tolerance and adverse effects, subjects' complaints about their experience, and additional nursing workload associated with NIV treatment were assessed. Results: Statistically significant improvements were obtained in arterial blood gas analysis, respiratory rate, and heart rate during treatment. In the first 2 h, 65% of subjects had poor mask compliance, patients' comfort scores were poor, and incompliance was associated with discomfort. The ratio of skin problems was 15% in the first 24 h and reached 60% at 48 h. The pain rate due to mask ties was 80% and then increased to 90% at 48 h. There was a significant relationship between the problems detected by the nurses and problems described by the subjects. Additional nursing workload was found as 110 min for 0–6 h. Conclusions: We observed that the mask compliance and comfort levels of the subjects were poor. Skin breakdowns increased depending on the duration of treatment. Treatment would require continuous nursing support in seven areas. NIV treatment generated a significant amount of workload for nurses. Additional nursing workforce planning is required for NIV units for successful NIV treatment.

Background: Urinary incontinence (UI) paves the way for many health problems ranging from discomforts of continuous wetness and irritation to social isolation and depression in women. Aim: The aim of this study was to determine the prevalence of UI in women aged 40 and older as well as its risk factors and also its effect on quality of life. Materials and Methods: This cross-sectional study was conducted with 286 women included in the sample. Subjects were selected randomly. The data were collected using a questionnaire, which was prepared by the researchers, and the Incontinence Quality of Life Questionnaire. The data were analyzed using number, percentage, mean, Chi-square test, and binary logistic regression analysis in the SPSS program. Results: It was found that 86 (30.1%) of the women experienced the symptom of UI. The women had mostly the mixed UI. The correlations between UI and age, educational level, status of employment, the presence of chronic diseases, chronic constipation, difficult birth history, and state of menopause were significant. Total mean score of the women with UI for the Incontinence Quality of Life Questionnaire was 73.62 ± 24.36 and the most affected domain of the quality of life field was social embarrassment. Conclusions: In the present study, it was found that UI was prevalent in Turkish women and impaired their quality of life. The results can help to provide education and counseling services to women in a society-sensitive manner.

Background: As enamel and finger buds have an ectodermal origin and grow at the same time, it might be supposed that factors and agents that affect dental caries might give rise to the diversity of dermatoglyphic dermal ridge patterns. Aim: The present study aimed to evaluate the relationship between dental caries and dermatoglyphics in 3 to 6-year-old Iranian children. Methods: The present case-control study was performed on 3 to 6-year-old children. The decayed, missing, and filled teeth (dmft) scale was used to evaluate the oral and dental health status in the participants. Then, the patients were divided into two groups: 1) The case group: patients with a dmft of ≥3 (101 cases); 2) the control group: those with dmft value of zero (86 cases). Afterward, using a fingerprint recording device, the fingerprints were obtained from both hands of the participants. Results: There was no significant relationship between the patterns of fingerprints and dental caries. The percentages of whorls, loops, and arches in the case group were higher than those in the control group; however, these differences were not statistically significant. Conclusion: Dermatoglyphic patterns could not be used as a variable for the detection or prediction of dental caries in Iranian children.

Objective: The present study aimed to investigate the potential of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and mean platelet volume (MPV) as prognostic markers in tinnitus patients at inflammatory process. Methods: This study consisted of 216 subjects (124 males and 92 females), Routine laboratory CBC test results were calculated in this study. All the patients were divided into three groups according to their hearing thresholds: a high frequency hearing loss-tinnitus group (HFHL-TN) consisted of 55 subjects, an hearing loss in all frequencies tinnitus group (AFHL-TN) consisted of 53 subjects and a normal hearing-tinnitus group (NH-TN) consisted of 51 subjects. The control group (CNT) included 57 age-and sex-matched healthy subjects. Results: NLR, PLR and MPV were observed in the HFHL-TN group when compared to AFHL-TN, NH-TN and CNT group (P < 0.001). An increase in NLR was observed in the AFHL-TN group compared with the CNT group (P = 0.004). The PLR value of the HFHL-TN group was significantly higher than that of the AFHL-TN (P = 0.028) and NH-TN,CNTgroup (P < 0001). The PLR value of the HFHL-TN group was significantly higher than that of the AFHL-TN (p=0.028) and NH-TN, CNT group (P < 0001). MPV values in HFHL-TN group was slightly higher AFHL-TN group and significantly higher than NH-TN (P = 0.025) and CNT (P < 0.001) group. Conclusion: Our results confirm that elevated NLR, PLR and MPV values has been suggested to be a useful inflammatuar prognostic biomarker of tinnitus patients.

Background: Dysglycemia (hyper- or hypoglycemia) is frequently seen in acutely ill children and may be associated with poor outcome. Objective: To determine and compare clinical characteristics and outcomes of children admitted for acute illnesses presenting with euglycemia and dysglycemia. A prospective cohort study was conducted in Emergency Pediatric Unit (EPU), of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Subjects and Methods: Children aged ≤15 years, admitted for acute illnesses were enrolled consecutively for a 6-month period. An Accu-Chek Active glucometer was used to check blood glucose of subjects at admission, and based on the result; subjects were categorized as either euglycemic or dysglycemic. The clinical characteristics and outcomes (discharged or died) were compared in the two groups. Statistical analysis involved Chi square test and logistic regression. Results: The median age of 376 subjects was 24 months (range: 1-156 months). Forty-four subjects (11.7%) had dysglycemia, consisting of 36 (9.6%) with hyperglycemia, and 8 (2.1%) with hypoglycemia, whereas 332 (88.3%) had euglycemia. The clinical characteristics associated with hyperglycemia were presence of fever (p = 0.001), and convulsion (p = 0.04), whereas hypoglycemia; coma and hepatomegaly (p = 0.01). Forty subjects (40/376, 10.6%) died. The proportion of those that died in the dysglycemic group (10/44, 22.7%) was significantly higher than that in the euglycemic group (30/332, 9%) (p = 0.006). Subjects who had hyperglycemia were 2.6 times less likely to survive (OR = 2.64, 95% CI: 1.02--6.79, P = 0.05) compared to their euglycemic counterparts. Hypoglycemia was not significantly associated with death outcome (p = 0.13). Conclusion: Dysglycemia, particularly hyperglycemia, was significantly associated with increased mortality in acutely ill children. We recommend routine bedside glucose estimation for all acutely ill children at admission to the emergency unit, to detect dysglycemia, treat hypoglycemia promptly, monitor closely, and treat aggressively the underlying conditions in children with hyperglycemia to prevent attendant high mortality.

Background: There is a strong relationship between arterial stiffness and endothelial dysfunction and hypertension. How arterial stiffness is affected in elevated PRL conditions is uncertain. Biological action of prolactin contributing to the atherosclerotic process is a new research area. Aims: We aimed at investigating cardiovascular risk predictability by conducting arterial stiffness measurement in patients with idiopathic hyperprolactinemia. Subjects and Methods: The biochemical parameters and arterial stiffness analyses of 54 patients with idiopathic hyperprolactinemia, who had applied to our polyclinic in 2017 and 2018, and 55 healthy volunteers having similar characteristics with regard to age, sex and body mass index. Results: The median prolactin level of the idiopathic hyperprolactinemia patients with a median age of 31 was found to be 45 ng/mL. The peripheral and central blood pressures and pulse wave velocities (PWV) of both the patient group and the control group were found to be similar. Any relations between prolactin levels and blood pressure and arterial stiffness could not be found. Discussion: Our study showed that arterial stiffness did not increase in young patients with idiopathic mild hyperprolactinemia. However, the long-term effects of mildly elevated prolactin levels are unknown. Prospective randomized studies are required, that could reveal more clearly the prolactin-cardiovascular risk relation, and the clinical effects of extra-pituitary hyperprolactinemia.

Objective: The objective was to in-vitro evaluate the mode of failure of abutments supporting fixed partial dentures (FPDs) via different retention techniques. Materials and Methods: Thirty-six implants with diameter and length of 4.5 and 13 mm, respectively, were used to prepare 18 samples of FPDs. Based on the variations on abutment's design, the FPDs were divided into three groups: Group A is cement-based retention; Group B is screw-based retention; and Group C is multiunit screw-based retention. Using a chewing simulator, cyclic loads of 1,250,000 load cycles with the load of 70N were applied on all samples to simulate 5 years of human functional chewing. The samples were loaded until failure using an electromechanical test machine. Sample-size estimation was done and fracture-load values were recorded as means and corresponding standard deviations; and group comparisons were done using one-way analysis of variance and Tukey's post hoc tests. A P value below 0.01 was nominated as an indicator of statistical significance. Results: In total, 36 samples (12 implant-abutment connections per group) were assessed. Abutment bending was observed in 6 (50%), 6 (50%) and 6 (50%) samples in groups A, B and C, respectively. De-attachment of the FPD form the abutment occurred in 5 (41.7%) and 5 (41.7%) samples in groups A and C, respectively. Screw fracture and fracture of FPD at the connector side occurred in 1 (8.3%) and 1 (8.3%) sample in groups A and C, correspondingly. Failure of the FPD was more often encountered in groups A (100%) and C (100%), compared to group B (50%). Conclusion: All abutments underwent failures under cyclic loading with abutment bending being the most common failure mode. Cement- and multi-screw-supported abutments fail more often than screw-supported abutments.

Background: Infections with Staphylococcus aureus cause significant morbidity and mortality worldwide. Resistant strains of S. aureus to commonly used antibiotics are being increasingly encountered in clinical practice, necessitating the need to determine the resistance pattern in Nigeria. Methods: Antibiotic susceptibility testing was performed on 360 S. aureus isolates from clinical specimen from seven hospitals across the six geo-political regions of Nigeria using Kirby Bauer disc diffusion technique, and E-test for vancomycin. Cefoxitin 30 μg disc was used to determine methicillin resistance, and D-test for inducible clindamycin resistance. Results: Methicillin-resistant S. aureus was confirmed in 176 (48.9%) of the isolates, 346 (96%) for penicillin G and 311 (86.4%) for trimethoprim. 175 (99.4%) of the 176 resistant to methicillin were susceptible to vancomycin. Linezolid, tigecycline, chloramphenicol and clindamycin had susceptibilities of 341 (94.7%), 332 (92.2%), 298 (82.8%) and 290 (80.6%) respectively. Inducible clindamycin resistance was elucidated in 25 (29.1%) of the 86 isolates. Generally, MRSA isolates were more resistant than methicillin-sensitive S. aureus (MSSA) to all antibiotics tested. Conclusion: Staphylococcus aureus rates of resistance are high and call for urgent action such as antibiotic stewardship programmes and periodic surveillance to enhance clinical outcomes. While targeted therapy is preferred, options for empiric treatment include chloramphenicol, clindamycin, linezolid or vancomycin.

Background: Antibiotic use in research volunteers partaking in dental studies varies widely, as inclusion and exclusion criteria used in participant selection lack strict rules. Aim: We aimed to investigate the most appropriate ending time of amoxicillin therapy in healthy subjects before their recruitment and participation in oral histology trials. A cross-sectional design study was conducted in Istanbul, Turkey, between October 2018 and June 2019. Subjects and Methods: Study participants who had undergone a previous course of amoxicillin were divided into three groups according to the amount of time since their last antibiotic dose: group I, within 1 month; group II, within 4–6 months; and group III, within 7–12 months. Periodontal parameters were measured, and smear samples were obtained from buccal mucosa and keratinized gingiva. Gingival biopsies were taken from the upper premolars. Genetic damage and histopathological damage were analyzed with Feulgen reaction and with hematoxylin–eosin staining. Data were analyzed using the Mann–Whitney U, Kruskal–Wallis, and the Pearson Chi-square tests. Results: There were no significant differences in the periodontal parameters and sociodemographic characteristics between the groups (P > 0.05). Higher genetic and histopathological damage scores were observed in group I, which were significantly different compared to the other groups (P < 0.05). No significant differences were observed between groups II and III (P > 0.05). Conclusions: When selecting healthy participants for oral histology trials, at least 3 months should pass after the final dose of amoxicillin is taken to avoid negative effects on gingival tissue and smear samples.

Aims: The aim of this study was to examine the substance-use history of young people in a rehabilitation center in Berlin with a therapeutic community structure, their thoughts about the rehabilitation process, and the evaluations of the center's employees. Methods: The study used interviews with the young people in the rehabilitation process and the professionals working in the institution as well as observation studies over a period of three-months. A total of 23 people participated in the study, including 13 young people in the rehabilitation process with a history of substance use and 10 professionals working at the institution. The researchers used a qualitative research method along with a three-month observation study. Results: After the interviews, 4 main themes and 5 sub-themes were identified among the young people with a substance-use history, and 4 main themes and 4 sub-themes were identified for the employees. Conclusion: It was determined that a well-structured rehabilitation center has positive psychological, social, cognitive, and behavioral effects on young people with a history of substance use.

Aims: To evaluate the effect of multiple-use and sterilization on cyclic fatigue and shaping ability of heat-treated nickel-titanium (NiTi) rotary instruments. Methods: A total of 120 acrylic blocks with S-shaped canals were photographed and prepared by HyFlex CM, ProTaper Next, and Twisted File. Ten new sets of each rotary instruments were used for four times. The autoclaving process was repeated after each use. Pre- and post instrumentation images were superimposed. The amount of resin removal and canal transportation by each system was measured in eleven different points. Instruments were subsequently subjected to a cyclic fatigue test in a double-curved artificial canal. The means and standard deviations of the number of cycles to failure (NCF) were calculated and statistically analyzed (P < 0.05). Results: No fractures occurred during the shaping of the simulated canals. The ProTaper Next removed the greatest amount of resin, whereas the Twisted File had the lowest values at all levels. Repeated clinical use and sterilization resulted in a decrease in the resin removal at most levels in Twisted File and ProTaper Next. In terms of canal transportation, an increase in a limited number of levels was detected after repeated use of all rotary files. Twisted File had the greatest cyclic fatigue resistance, followed by HyFlex CM and ProTaper Next (P < 0.05). Conclusions: The effects of repeated use and autoclaving on the cyclic fatigue resistance of HyFlex CM, ProTaper Next, and Twisted File were not significant. Canal transportation increased mostly in the apical region. The amount of resin removal decreased as the number of use increased for ProTaper Next and Twisted File instruments.

Background: It is a well-known fact that the parents play a key role in the early intervention program for their deaf and hard of hearing children. Aims: This study aims to focus on issues related to the need for a collaborative, supportive and parent centred early intervention programs and (re)habilitation process for the children with hearing aids or cochlear implants for sustainable health. This study was a retrospective case control study. Subject and Methods: Sixty parents (30 parent educated and 30 non- parent educated) were completed a Profile Questionnaire and a Family Awareness and Knowledge Questionnaire. The first questionnaire was designed to obtain the information related with the demographics of the family and their deaf or hard of hearing children. The latter was used to evaluate the knowledge of parents about their hearing handicapped children. All statistical analyses were performed with IBM SPSS Statistics, Version 22.0 software (Armonk, NY: IBM Corp). Results: The parent awareness and knowledge of children with cochlear implants differed from those of control group who do not receive any family counselling, but not in clinically significant ways. Conclusions: Some of the variability in cochlear implantation outcomes that have protracted periods of development is related to family environment. Because the family environment can be modified and enhanced by therapy or counselling, these preliminary findings hold promise for future work in helping families for sustainability in health.

Objective: To assess the emotional intelligence and identify the perceived sources of stress among female dental students and interns at King Khalid University College of Dentistry (KKUCOD), to investigate whether specific stressors were related to the year of study and gender, and to evaluate the relationship between emotional intelligence (EI) and perceived stress (PS). Materials and Methods: Total of 150 female undergraduates from 5^th and 6^th years and dental interns were invited to complete a questionnaire using face-to-face interview. Data on EI was collected using a scale developed by Schutte et al. while a modified version of the Dental Environment Stress (DES) was applied to assess the stress perceived by dental students. Results: 120 students agreed to join the study with a response rate of 84%. Mean EI score for the sample was 120 (SD = 11.56), and the mean PS score was 70.37 (SD = 16.19). One-way ANOVA revealed a significant difference between different age groups and the educational, environmental score (P < 0.05). Correlational analysis showed that the PS scale and its factors correlated positively with each other (P < 0.01) and directly with the total EI score (P > 0.01); except for the living accommodation factor, negative correlations with overall EI score were significant. Conclusion: The present study showed that female interns and undergraduate students in clinical years of study at College of Dentistry reported higher EI and PS. The educational environmental score was found to be significantly different among different age groups. In contrary to most published literature, a direct association between EI and PS scores was found, except for the living accommodation factor. This might be attributed to the fact that the study was conducted 1 month prior to final exams. Living accommodation, personal factors, educational environment, academic work and clinical factors were identified as significant predictors of PS.

Background: Diabetes and periodontitis are two chronic inflammatory diseases sharing specific etiopathogenetic mechanisms, and both cause severe inflammation and destruction. Aims: The present study aimed to determine the receptor expressions of peroxisome proliferative-activated receptor (PPAR)-γ, retinoid X receptor (RXR)-α, vitamin D receptor (VDR), and nuclear factor kappa B (NF-κB) expressions in healthy gingiva and diseased gingival samples with or without diabetes. Methods: Forty-five participants as (1) healthy controls (C), (2) periodontitis group (P), and (3) diabetes and periodontitis group (DP) were enrolled. Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment levels (CAL), and bleeding on probing (BOP) were recorded in all participants. Two gingival biopsies from each participant were obtained, and one underwent histological tissue processing while the other underwent qRT-PCR analysis of nuclear receptors. Inflammatory and fibroblast cell counts, PPAR-γ, RXR-α, VDR, and NF-κB were evaluated. Results: Fibroblast cells were lowest in the DP group and highest in the healthy group. PPAR-γ, VDR, RXR, and NF-κB expressions were higher in the healthy controls in the qRT-PCR analysis and similar in the other groups. Immunohistochemistry analysis also showed similar results. Conclusion: qRT-PCR results concluded that healthy gingival samples had higher PPAR-γ, RXR, VDR, and NF-κB expressions, and immunohistochemistry findings supported the results. In addition, healthy gingiva contained higher fibroblast cells and lower inflammatory cells.

Aims: The aim of this study was to assess the effect of intraarticular glucocorticoid injections on blood glucose levels in diabetes mellitus (DM) and non-DM patients with adhesive capsulitis of the shoulder and investigate the risk factors for hyperglycemia. Methods: The study included 40 DM and 38 non-DM patients. The DM status, HbA1c levels, baseline fasting blood glucose (FBG) level, and post-injection 1-, 7-, 15-, and 21-day FBG levels were evaluated retrospectively. Results: The FBG levels were significantly higher 1 and 7 day after the glucocorticoid injection as compared with the baseline levels (P = 0.001 and <0.001, respectively). The increase was greatest in DM patients and then returned to baseline levels 15-day post-injection. In terms of the mean difference in post-injection and baseline FBG levels, the increase on day 1 was statistically significantly greater in the DM group as compared with that in the non-DM group (P = 0.01). Linear regression model showed that only the baseline FBG level predicted the glucose level 1-day post-treatment (β = 0.839, P < 0.01). Conclusion: Intraarticular glucocorticoid injections can safely be administered as a treatment for adhesive capsulitis of the shoulder in patients with well-controlled DM. Baseline FBG levels may predict peak blood glucose levels in patients with well-controlled DM. We recommend that DM patients with adhesive capsulitis should undergo frequent monitoring of blood glucose in the 2 week following intraarticular glucocorticoid injection treatment.

Aims: To evaluate the effect of various aging periods and different surface preparation methods on microtensile bond strength (μTBS) for composite repair. Materials and Methods: One hundred twelve composite resin blocks were formed using a nanohybrid composite resin. The samples were distributed into four groups according to surface preparation methods (n = 28): control (sound composite blocks); Er, Cr: YSGG laser; air abrasion; silicone carbide. All samples were then divided into four subgroups according to various aging periods: (i) No aging, (ii) 10,000 thermocycling, (iii) 30,000 thermocycling, and (iv) 50,000 thermocycling. Following surface preparation and aging procedures, surface topography of one sample from each group was evaluated under scanning electron microscope (SEM). The repair composites were bonded to the sample surfaces, using a three-step etch&rinse adhesive. Finally, thirty beams of size 1 × 1 × 8 mm from each group were subjected to μTBS test and failure modes were determined. The data were analyzed using two-way ANOVA, Post-hoc Bonferroni, and Chi-square tests (P = 0.05). Results: When different surface preparation methods were evaluated together, no aging and 10,000 thermocycling groups displayed higher μTBS values (P < 0.05). When all aging periods were evaluated together, the surface preparation with air abrasion provided higher μTBS (P < 0.05). The interactions of various aging periods with different surface preparation methods revealed significant variations in repair μTBS (P < 0.05). There were statistically significant differences on failure mode distributions among surface preparation methods (P < 0.001). SEM evaluations provided valuable outcomes that help to comment on the μTBS findings. Conclusions: Different surface preparation methods, various aging periods, and the interaction of both affected the repair μTBS of the tested nanohybrid composite resin.

Myxomas are slowly growing mesenchymal tumors and are considered as extremely rare benign tumors of small intestine. This is the case of a young woman presenting with acute bowel obstruction due to ileo-ileal intussusception caused by an intraluminal 4- cm solitary nodule, found to be a myxoma upon pathologic examination, after resection by surgery.

Tracheobronchial foreign body aspiration (FBA), a common pediatric presentation to emergency departments, is still a public healthcare problem affecting children all over the world. There are several types of foreign bodies reported from different parts of the world, including both organic or nonorganic substances. Pica, another interesting clinical entity, is characterized by persistent eating of nonnutritive substances, which is inappropriate for the maturation stage of the individual. A 3-year-old pediatric patient was admitted to our emergency department with a 3-day history of coughing and new onset respiratory distress. A chest X-ray was performed and it showed a suspicious radiopaque foreign body in the localization of left bronchi. Urgent rigid bronchoscopy was performed. The foreign body in the left main bronchi was, surprisingly, a 0.5–1 cm diameter, irregularly shaped stone particle. The laboratory evaluations and patient history revealed the diagnosis of severe iron deficiency anemia and accompanying pica. Stone aspiration, as an FBA, is a rare but potentially life-threatening complication of pica. Iron deficiency anemia accompanied by pica should be diagnosed and treated in the early stage of the disease because of their complications. According to our knowledge and literature search, this is the first case of stone aspiration as a complication of severe iron deficiency anemia and pica.