Objective: To ascertain the barriers to utilization of cataract surgery in Ekiti State, south western Nigeria. Methods: A semistructured questionnaire was used to extract relevant data from cataract patients seen during six episodes of free eye screening conducted quarterly across the three senatorial districts of the state for a 15-month period. The questionnaire contains relevant biodata and reasons why the patients did not utilized facilities for routine cataract surgery prior to the screening exercise. The data obtained were coded and analyzed using the Statistical Package for Social Sciences (SPSS) version 15. Results: A total of 132 patients were analyzed for the study, The study group comprised 64 males (48.5%) and 68 females (51.5%). Age range 16-95 years with a mean of 64.8 years ± SD 16.5. Forty of them (30.3%) were bilaterally blind, whereas 92 (69.7%) were uniocularly blind from cataract. The most common reason for not utilizing routine cataract surgical services was financial constraint as claimed by 65 (49.2%) of them; other reasons include ignorance 38 (28.8%), medical illness 24 (18.2%), and fear 5 (3.8%). Conclusion: Financial constraint is the most common barrier to utilization of routine cataract surgery in Ekiti, State. Ignorance is also a significant factor in our environment.

Aim: To explore the microleakage of different adhesive systems and flowable composites to permanent teeth. Subjects and Methods: In this study, a total of 84 human premolar teeth were used. Class V cavities were prepared on the buccal surfaces. The teeth were randomly assigned to six groups of 14 teeth each as follows: The first group – etch-rinse adhesive applied and cavities filled with flowable composite, the second group – etch-rinse adhesive applied and cavities filled with bulk-fill resin composite, the third group – one-stage self-etch (SE) adhesive applied and cavities filled with flowable composite, the fourth group – one-stage SE adhesive applied and cavities filled with bulk-fill resin composite, the fifth group – two-stage SE adhesive applied and cavities filled with flowable composite, and the sixth group – two-stage SE adhesive applied and cavities filled with bulk-fill resin composite. All specimens were then stored for 24 h at 37°C in distilled water. Teeth were then thermocycled for 500 cycles between 5°C and 55°C prior to immersion in 0.5% basic fuchsin for 24 h. Two mesiodistal cuts of each tooth were photographed for leakage with a digital camera. The dye infiltrated surface for each specimen was measured and data were collected with a software program. Statistical evaluations were done by nonparametric Kruskal–Wallis test and Mann–Whitney U-test. Results: There were statistically significant differences in mean microleakage ratio among the groups (P < 0.05). The first group had shown significantly increased microleakage areas than the other four groups (third, fourth, fifth, and sixth groups) (P < 0.05), except for the second group (P > 0.05). It was also no significant different between the mean microleakage areas of group fourth and group fifth (P > 0.05). The sixth group had exhibited the lowest microleakage areas, and it was statistically significant (P < 0.05) compared to the other groups. Conclusion: In this study, it has been found that the use of total etch adhesive systems resulted in high leakage values.

Background: Expandable nails achieve stability only by hydraulic expansion; therefore suggest less radiation exposure and operation time. In this study, we aimed to compare the results of expandable femoral nails with locked intramedullary nails in the treatment of diaphyseal fractures of femur. Materials and Methods: Isolated closed AO = Arbeitsgemeinschaft für Osteosynthesefragen type 32.A or 32.B unilateral femoral shaft fractures operated with expandable or locked nail were evaluated retrospectively. We match patients who undergone expandable nail fixation with patients of the same-sex, age, and fracture type who undergone locked nailing. A match was done for 31 expandable nail. At follow up, healing was assessed radiologically and clinically. Outcome measures included duration of hospital stay, time taken to achieve bony union, and participation in full activities. Results: The average duration of surgery in the expandable group was 60.9 min and in the locked group was 82.4 min. In the expandable group, the average clinical healing time was 15.5 weeks and radiographic healing time was 21.7 weeks. In the locked IMN group, the average clinical healing time was 18.4 weeks and the average radiographic healing time was 24.1 weeks. We observed seven (22.6%) non-union in expandable group and four (12.9%) non-union in locked group. In the expandable group, type of the fracture was AO 32.B in all of the non-union patients. We achieved union in all of non-unions of the locked group only with dynamization. In the expandable IMN group, five (16.1%) patients required major surgery, in the locked group none of the patients required major surgery. Conclusion: Non-union rate of the expandable nail is higher than that of the locked nail for femoral diaphyseal fractures. It may be a treatment option in simple fractures like AO 32.A and in patients where rapid fixation is demanded. It has advantages of reduced operative time and less radiation exposure in comparison with reported series of conventional nails.

Objectives: To determine the metabolic abnormalities among Hepatitis C Virus (HCV) co infected HAART naïve HIV infected persons within the adult ARV clinic of the University College Hospital/University of Ibadan, Ibadan, Nigeria Methods: This was a retrospective study involving the review of clinical records of newly recruited HIV-infected persons in the adult antiretroviral (ARV) clinic over a 12 month period (January - December 2006). Baseline results for fasting plasma glucose (FPG) and fasting lipid profile were retrieved. Results: Out of the 1,260 HIV infected persons seen during the study period, HCV co-infection was found in 75 (6%) persons. The median values for total cholesterol, LDL-cholesterol and HDL-cholesterol were lower in the HCV co-infected persons. HIV-HCV co–infection was associated with a 0.31 mmol/L depression in Total Cholesterol (TC). The median FPG concentration was significantly higher in HIV-HCV co–infected than HIV only infected persons (5.33mmol/L vs. 5.00mmol/L, p = 0.047). However, regression analysis showed there was no relationship between the HIV-HCV co infected state and fasting glucose levels. Conclusion: HIV-HCV co-infection may be associated with a predictable decline in plasma cholesterol, but FPG may not be sufficient to demonstrate insulin resistance in these persons.

Background: Inappropriate use of antibiotics by clinicians leads to antibiotic resistance, and is a serious global health concern. Aim: The aim of this study was to determine antibiotic prescription practices of dental practitioners and their adherence to professional guidelines while treating oral health problems among children. Materials and Methods: All the dentists working in Jeddah were invited to participate and 126 dentists consented to be a part of this study. A two-part questionnaire was applied. First section explored the demographics and questions related to antibiotic use for certain dental clinical procedures, whereas the second section used five different clinical case scenarios to elicit the antibiotics prescription practices and adherence to professional guidelines by the dentists. Results: Amoxicillin (73.8%) was the most commonly preferred antibiotic for most of the orofacial infections among the dentists. The overall adherence to the professional guidelines ranged from 9.5 to 45%. Conclusions: A lack of consistency in the antibiotic prescription pattern among dentists in Jeddah and overall low adherence to the professional guidelines was observed.

Objective: To document our experience with the use of the Bonanno catheter as a closed abdominal drain for OHSS Methods: A retrospective study of all IVF embryo transfer (ET) treatment cycles carried out between May 2006 and April 2009 at a dedicated IVF centre. Case notes of patients with OHSS were retrieved and the outcome of the continuous closed abdominal drain with Bonanno catheter documented. Result: Within the period under review, 234 patients had controlled ovarian stimulation with ultrasound guided egg retrieval. Two hundred and twenty eight (228) got to the stage of embryo transfer with 72 clinical pregnancies. The clinical pregnancy rate was 31.58%. Fourteen (6%) of those who were stimulated developed OHSS and had a closed abdominal drain of the ascitic fluid using the Bonanno catheter. The average number of days of the abdominal drainage was 7.5days and the average volume of ascitic fluid drained from a patient per day was 2454.9 + 748mls. Eight (8) patients who had OHSS achieved clinical pregnancy (six intrauterine, one ectopic and one heterotopic pregnancies), giving a clinical pregnancy rate of 57.14% in patients with OHSS. Four patients had blocked Bonanno catheters and three of them had the catheter changed while the fourth had the catheter successfully flushed. Four patients had the insertion site dressing changed due to soaking with ascitic fluid. There was no incidence of injury to intra abdominal organs or broken catheter. Conclusion: Bonanno Catheter is both effective and safe in draining ascitic fluid following OHSS.

Background: Homozygous sickle cell patients are prone to renal damage which can be on-going in and out of crises, therefore, there is a need to monitor renal status using glomerular filtration rate. Equations to estimate GFR are readily available. Cockcroft-Gault equation is widely used, while the MDRD formula is the currently accepted equation. The CKD-EPI equation is recently being recommended but has not been validated among HbSS patients. Therefore, we aim to compare estimated GFR using CKD-EPI versus MDRD and Cockcroft-Gault equations among HbSS patients. Material and Methods: This was a cross-sectional study of stable HbSS patients. Information on their age, sex, and weight was collected. Their venous blood samples were also obtained for plasma creatinine determination which was used to calculate estimated GFR using Cockcroft-Gault, MDRD and CKD-EPI equations. Student t-test, Pearson correlation, and Bland-Altman difference plots were performed. A p-value of < 0.05 was considered to be significant. Results: One hundred and twenty patients comprising 60 HbSS patients and 60 HbAA controls participated in the study. The HbSS patients had mean ± SD age of 26±6.7years, plasma creatinine 77 ± 17umol/L, eGFR: CG 93±31.6ml/min, MDRD 124 ± 34.8ml/min/1.73m², CKD-EPI 122 ± 25.1ml/min/1.73m² (p<0.0001). Hyperfiltration was observed in 20(33.3%) of the HbSS patients. CKD-EPI had stronger positive correlation with MDRD (n = 60, r = 0.93) and less bias (SD = 14.7) than with CG (n = 60, r = 0.76, SD = 20). Conclusion: CKD-EPI equation is best for individuals with GFR > 60ml/min/1.73m². This study has shown that it correlates well with the currently acceptable MDRD equation, therefore, can be used to monitor the renal status of stable HbSS patients. CG gives poor correlation and bias with CKD-EPI. Further validation studies on CKD-EPI equation are needed in different patient populations.

Background: Recently, manufacturers have introduced bulk-fill composite resins that reportedly can be placed in increments of 4 mm or greater. Objective: The purpose of this article was to report the results of 12 months prospective randomized clinical trial that evaluated the clinical performance of one high-viscosity bulk-fill composite resin in Class II cavities of posterior teeth. Materials and Methods: Thirty-four participantshad at least two Class II cavities included the study. Class II cavities restored with either a Tetric EvoCeram bulk-fi fill or universal nano-hybrid resin composite (Tetric EvoCeram). A total of 74 restorations (37 with each material) on 34 patients were placed according to the manufacturers' instructions by one calibrated operator. Results: Seventy restorations were evaluated after 12 months evaluation period. No postoperative sensitivity, anatomic form, retention, and secondary caries were observed after 6 and 12 months. Regarding the items color match, marginal discoloration, and marginal adaptation, the statistical analysis did not detect any statistical significance between two materials (P > 0.05). Conclusion: After 12 months of clinical service, all restorations evaluated for both materials were classified as ideal, receiving predominantly Alfa scores for all parameters analyzed. Clinical Relevance: This study presents that high-viscosity bulk-fill resin composites (RCs) perform just as well as nano-hybrid RCs with the 2 mm RC layering technique, therefore could be alternative to conventional nano-hybrid RCs.

Aim: The aim of the study was to provide a comparative evaluation of the clinical and radiographic success of Ankaferd blood stopper (ABS), formocresol (FC), and ferric sulfate (FS) as pulpotomy agent in primary teeth. Settings and Design: This is a clinical study. Materials and Methods: A total of 45 primary mandibular molar teeth in 26 children aged 6–9 were selected for the study. Teeth were randomly divided into three groups according to the pulpotomy agents (ABS, FC, FS). Following treatment, for 24 months, teeth were clinically and radiographically evaluated once every 3 and 6 months respectively. Statistical Analysis Used: SPSS version 15 software was used in data analysis. Kaplan– Meier, Log Rank and Fisher's exact tests were used to analysis. Results: After follow-up periods ranging from 6 to 24 months (average 20.8±0.56), the clinical success rates for ABS, FC, and FS were 87%, 87%, and 100% respectively. The overall radiographic success was 87%, 80%, and 87%. When success rates of the ABS were compared with other agents, there were no significant differences between groups (P > 0.05). Conclusion: Similar success was achieved in the pulpotomy treatment of primary teeth that using ABS, FC, and FS. ABS would be considered a suitable agent for pulpotomy treatment and can be used as an alternative to other agents.

Background: Overweight and obesity in children, and adolescents is on the rise globally. Affected children are prone to cardio-metabolic problems later in life, especially hypertension. The prevalence of obesity/overweight may differ depending on school type. Private schools are attended mostly by children of the affluent, while public schools are attended predominantly by those in the low and middle socio-economic classes. Objective: To compare the prevalence of overweight, obesity and elevated blood pressure (BP) in pupils attending public and private primary schools in an urban community in Nigeria. Materials and Methods: In this cross sectional study, the BMI and BP of pupils in public and private primary schools, recruited by multistage sampling method, were measured. Their nutritional status was categorized using their BMI percentiles. Analysis was by SPSS. Results: A total of 1466 pupils were recruited, 814(55.5%) were in public schools and 722(49.2%) were males. The prevalence of overweight and obesity was higher in private schools 11.8% and 11.7% compared to public schools 3.3% and 0.9%. The mean systolic BP of pupils in public schools 96.8 ± 12.5 mmHg was higher than that in private schools 95.5 ± 10.2 mmHg, p = 0.032. Distribution of pupils with prehypertension and hypertension between private and public schools was not significantly different. Conclusion: The prevalence of overweight and obesity is higher in pupils attending private schools compared to those in public school. Urgent measures are needed to stem this tide through education, weight reduction and physical activity programs, especially in pupils attending private schools.

Objective: Understanding potential problems associated with primary double teeth (PDT) are important to provide prophylactic measures, thereby preventing or minimizing possible complications. The purposes of this study were to investigate the prevalence of PDT in a group of Turkish children and to compare the distribution of the different types of double primary teeth and their relationship to permanent successors. Materials and Methods: A total of 17,268 children underwent a clinical examination to determine the presence of PDT. One hundred fifty-two PDT of 128 children were included in this study. All the 128 children with PDT underwent a clinical examination and had photographs taken at the time of the examination. The children underwent a further periapical or panoramic radiographic examination to determine the status of the underlying permanent successors. The PDT was classified according to Aguilo's classification. Results: The prevalence of PDT was 0.74%, with no significant statistical difference between the sexes. PDT was most frequently observed between the mandibular lateral incisors and canines. Of the 152 PDT, 10.7% were Type I, 15.3% were Type II, 26.1% were Type III, and 47.9% were Type IV. Dental anomalies on the succedaneous permanent teeth were diagnosed in 69.4% of the children with affected primary dentition. Aplasia of the permanent lateral incisor was observed most frequently in association with Type I (52.7%) PDT. Caries involvement was observed most frequently in Type III (56.2%) PDT. Conclusion: The findings of this study have clinical relevance for the diagnosis of children with PDT. Early clinical and radiographic identification of PDT can help the clinician to evaluate the number and condition of permanent successors and draw up a proper treatment plan.

Objective: This study examined the usefulness of maternal anthropometry in predicting the birth size of term singleton newborn infants at NAUTH, Nnewi, Nigeria. Materials and Methods: A cross-sectional study was conducted among 301 mother/newborn infant pairs. Results: The mean birth weight was 3.27 ± 0.60 kg whereas the incidence of low birth weight and fetal macrosomia were 8.0% and 11.3%, respectively. The anthropometric indices varied in their ability to detect newborn babies who experienced abnormal intrauterine growth. The rate of subnormal intrauterine growth was 9.0%, 11.6%m and 18.6% using weight-for-gestational age (GA), ponderal index (PI), and mid-arm circumference (MAC)/occipito-frontal circumference (OFC) criteria, respectively. On the other hand, the rate of excessive intrauterine growth was 16.6% and 12.0% using weight-for-GA and PI criteria, respectively. Apart from maternal height, all the assessed maternal anthropometric parameters had a significant relationship with size at birth. Mothers of newborn infants who experienced subnormal intrauterine growth were more likely to have MAC < 25 cm, intrapartum weight < 65 kg, intrapartum BMI < 25 kg/m², and rate of third trimester weight gain < 250 g/week. On the other hand, mothers of newborn infants who experienced excessive intrauterine growth were more likely to have MAC > 30 cm, intrapartum BMI ≥ 30 kg/m², and rate of third trimester weight gain ≥ 500 g/week. Conclusion/Recommendation: Maternal anthropometry is a very useful tool in identifying mothers at risk of having newborn infants who experienced abnormal intrauterine growth. Therefore, its routine application is recommended to enable such mothers benefit from interventions targeted at ensuring optimal intrauterine growth and improved pregnancy outcomes.

Background: Isotretinoin is the most effective therapy to treat severe acne vulgaris and its systemic adverse effects have been well documented, but little is known on dental side effects over the course of treatment. Objectives: This prospective case-control study aimed to evaluate the oral adverse effects of isotretinoin in Turkish patients with acne vulgaris; compare oral conditions between patients and normal controls; and investigate the association between salivary parameters and International Caries Detection and Assessment System (ICDAS) scores. Materials and Methods: For 6 months, the patients (n = 45) received isotretinoin daily (0.5 mg/kg). The age-matched untreated controls (n = 45) were patients without acne. Both groups were examined before the study and at 6 months for salivary flow, buffer capacity, microbiologic tests, and caries status (based on the ICDAS). Salivary parameters and ICDAS scores were analyzed by Spearman's rank correlations. Data were statistically analyzed by the Mann–Whitney U test, Wilcoxon signed rank tests, and McNemar's Chi-square tests (P < 0.05). Results: Twenty-two isotretinoin-treated patients and 18 controls completed the study. At baseline, the groups were not significantly different in the evaluated parameters (P > 0.05). At 6 months in the isotretinoin-treated group, salivary flow and buffer capacity significantly decreased, and the ICDAS scores significantly increased (P < 0.05). The changes in these criteria from baseline were insignificant in the controls (P > 0.05). Intraoral pathogen counts were not significantly different between the groups, compared to baseline (P > 0.05). Stimulated salivary parameters in both groups were not correlated significantly with the ICDAS scores. Conclusions: Isotretinoin significantly affected salivary flow, buffer capacity, caries lesion activity scores for 6 months. However, salivary parameters and caries lesion activity scores had no significant correlations.

Background: There has been increasing incidence of occupational diseases among woodworkers due to exposure to preventable hazards in the workplace. The objective of this study was to determine the effects of health education on the knowledge and practice of workplace hygiene and protective measures among woodworkers in Enugu timber market. Materials and Methods: This was a before and after study conducted among 290 woodworkers using interviewer administered semi-structured questionnaire and manual on workplace hazards prevention. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 17 and P-value of 0.05 was set as the significance level. Results: Two hundred and ninety respondents participated in the study; 282 (97.2%) were males, most completed secondary education and had worked for less than 10 years (71% and 58.3%, respectively). The mean knowledge score of participants pre- and postintervention were 89.5% ± 9.03 and 98.5% ± 1.84, respectively (P < 0.001). Educational status had effect on knowledge of participants (P < 0.001), whereas work experience had no effect (P = 0.285). Preintervention, 37.9% of the participants used protective materials regularly, which increased to 65.8% post intervention (P < 0.001). Personal hygiene practices showed mixed responses most of which improved post intervention. The most common reason for eating in workplace was excessive workload (60.3%), while lack of PPEs (29.3%) and lack of training (23.8%) were the most common reasons for nonuse of PPEs. Conclusion: Majority of the participants had good knowledge of workplace hygiene but had poor use of PPEs. Health education intervention improved the use of PPEs and should be recommended.

Context: Rapid population ageing is a demographic reality in most countries of the world. Old age is associated with changes which may culminate in health problems, necessitating provision of appropriate preventive, curative, and rehabilitative services. However, reports from many low- and middle-income countries have shown lack of preparedness to cater for the healthcare needs of older persons. Aim: This study described the morbidity profile and its determinants among persons aged 60 years and above who presented at an established geriatric centre in southwestern Nigeria. Materials and Methods: Data were obtained from electronic health records of 4886 patients aged ≥60 years who visited the facility between 1^st January 2013 and 31^st December 2014. Data were analyzed using Stata version 13 (Texas, USA). Frequency distributions were used for descriptive analysis, and chi-square test was used to test associations. Results: More than a half, 2919 (59.7%), of the respondents were females and almost three quarters 3501 (71.7%) were aged between 60 and 74 years. Mean number of morbidities was 1.81 ± 0.9, and less than half, 1097 (42.0%), presented with only one morbidity, most commonly, hypertension. There were significant age-related differences for musculoskeletal (P = 0.001), endocrine (P = 0.01), and psychological problems (P = 0.01). In addition, gender differences were observed as a significantly higher proportion of females presented with general symptoms (P = 0.02) and musculoskeletal problems (P = 0.0001) than men. Conclusion: The most common presenting morbidities at this geriatric health centre were mostly noncommunicable diseases. Information obtained will be useful in the design of similar facilities in other parts of the country and region at large.

Purpose: The aim of this study was to determine the age, gender, and sites of different types of odontogenic cysts (OCs) and non-OCs (nOCs) (seen in eastern Anatolian population in Turkey. Materials and Methods: The following data were collected from the clinical records and histopathology reports of the Department of Oral and Maxillofacial Surgery and the Department of Oral Pathology, Ataturk University, Turkey, during a period of 10 years. They were analyzed descriptively in terms of incidence, age, sex, cyst type, and site. Results: A total of 526 cysts were diagnosed during a 10-year period. Of these, 330 (62.7%) were in males, and 196 (37.3%) were in females, the male:female ratio was 1.7:1. There were 509 (96.8%) OCs and 17 (3.2%) nOCs. There were 406 (77.2%) inflammatory OCs and 103 (19.6%) developmental OCs. Radicular cysts were the most frequent (66.4%), followed by dentigerous (19.2%) and residual (10.8%) cysts. Only nasopalatine duct cyst was found as nOC in this study (3.2%). Conclusion: The distribution of jaw cysts in the Turkish Eastern Anatolian population is relatively similar to that of other populations reported in previous studies in the literature, in which most OCs were of inflammatory origin. However, the relative rates of cysts were higher than those reported in other studies.

Purpose: Though most doctors in their professional life will provide care for people with epilepsy, many will not get further training in their professional life. There may be other barriers, perceived or not, to providing care to people living with epilepsy by doctors which need to be approached in the medical undergraduate curriculum and medical continuing education. The aim of this study was to determine the knowledge gaps of medical students on basic issues regarding epilepsy that could be useful in preparing training material for the students and continuous medical education for doctors working in the community. Materials and Methods: This cross-sectional and descriptive study was carried out in one of the medical schools in Enugu metropolis. Data collection was done using a semi-structured validated questionnaire. Results: Seizure was regarded as a movement disorder by 10.3% of the students. The rank of causes of epilepsy given by respondents was brain injury (88%), brain tumor (87%) genetics (62.3%), and strokes (55.1%). Significantly more students who did neurology posting correctly answered that stroke is a risk factor (P < 0.001), disagreed that sleep deprivation is a risk factor (P = 0.04), and recognized different seizure types (P < 0.001–0.002). The mean score was 17.8 ± 2.3% (71.2 ± 9.2%); significantly higher in those who did neurology posting. Students scored lowest on questions regarding risk factors and duration of treatment. Conclusion: The content of medical curriculum in Africa should emphasize not only the content of lectures on epilepsy but also the need for students to go through neurology posting during their training. The outcome would be both better knowledge and improved physician–patient relations.

Background: Battered women are exposed to multiple types and different severity of intimate partner abuse, however, little is known about the relationship between severity and different types of intimate partner violence (IPV) (physical, sexual, psychological, and danger) and symptoms of depression and suicidal behavior in a sample of women attending antenatal care or general outpatient hospital services in Thailand. Materials and Methods: A cross-sectional study was conducted among adult women who were consecutively sampled and screened for IPV in antenatal care and general outpatient clinics in nine randomly selected hospitals in two provinces in the central region. The measures included the “Severity of Violence Against Women Scale,” “Edinburgh Postnatal Depression Scale 10,” “Danger Assessment Scale,” and one item for suicidal behavior. Hierarchical regressions were used to assess the effects of the different types of IPV on depression and suicidal behavior. Results: Of the final sample (N = 207) that screened positive for IPV, 49.3% scored positive for depression, and 17.6% reported suicidal threats or attempts in the past 12 months. One type of IPV (sexual) was significantly associated with depression, whereas psychological abuse and femicide risk or danger was correlated with suicidal behavior. Conclusion: A high proportion of women with IPV suffered from depression and suicidal behavior. The study provides evidence of an association between the severity of IPV and mental health problems (depression and suicidal behavior). In assessing IPV, the different identified dimensions contributing to poor mental health should be incorporated.

Objective: We aimed to examine neuropsychiatric symptoms of patients with early and advanced stage Parkinson's disease (PD). Materials and Methods: The study was performed at Kocatepe University Neurology Department in Turkey, comprised 46 PD patients and 46 controls. Hoehn-Yahr (HY) scale was used to evaluate the clinical stages of PD and Unified Parkinson's Disease Rating Scale (UPDRS) was used to evaluate the severity of clinical signs. Cognitive functions were evaluated by Mini-Mental State Examination (MMSE) and neuropsychiatric findings were evaluated by Beck Depression Inventory (BDI), Scale for the Assessment of Positive Symptoms (SAPS), and Scale for the Assessment of Negative Symptoms (SANS). Results: Significant difference was determined between BDI values of patients (13.28 ± 9.04) and control group (9.71 ± 5.19) (P = 0.02). Significant difference was determined with SANS (23.84 ± 15.42, 2.58 ± 3.13, P < 0.001) but not with SAPS (1.36 ± 4.16, 0.15 ± 0.43, P = 0.07). The patients were evaluated according to the HY stages and there was no significant difference between mild and severe symptom groups in respect of BDI, SAPS, and SANS values (P = 0.91, P = 0.31, and P = 0.29). According to gender, no significant difference was found between groups in respect of BDI, SAPS, and SANS values (P = 0.60, P = 0.54, and P = 0.67). No correlation was found between BDI, SAPS, SANS values, and HY stages. Conclusion: Higher rates of depression and negative symptoms were observed in patients with PD compared with healthy individuals. Results did not differ with different stages of PD. Therefore, it should be kept in mind that neuropsychiatric symptoms can be seen from the early stages of the disease and should be treated earlier.

Clinical reports of symptomatic intraocular metastasis as the initial presentation of lung cancer are rare. We report the case of a 49-year-old female patient who presented with loss of vision due to choroidal metastases as the initial manifestation of her disseminated lung cancer. This particular patient was referred to us from ophthalmology department as a case of choroidal metastases from unknown primary. Detailed evaluation at our department helped detect the primary to be a nonsmall cell carcinoma of the right lung, which had multiple distant metastases.

Clinical reports of symptomatic intraocular metastasis as the initial presentation of lung cancer are rare. We report the case of a 49-year-old female patient who presented with loss of vision due to choroidal metastases as the initial manifestation of her disseminated lung cancer. This particular patient was referred to us from ophthalmology department as a case of choroidal metastases from unknown primary. Detailed evaluation at our department helped detect the primary to be a nonsmall cell carcinoma of the right lung, which had multiple distant metastases.

Hiccups affect life quality, career and family life when they become persistent. We present here a 54-year-old man who worked as a mason and a blacksmith with hiccups complaint for nearly one and a half years. In this period, he was admitted to emergency service ten times with fainting or almost fainting, cold sweating and hand stretching complaints. The patient expressed that he frequently threw up when he had hiccups and his social life was negatively affected. He reported that he was treated with baclofen, esomeprazole and hyoscine-n-butyl bromur without relief. He used escitalopram and chlorpromazine for a short time and quit because they negatively affected his sleeping. As he did not have any relief from medications, he refused any oral medical therapy including gabapentin and started to seek remedy from paramedical treatments resulted with no benefit. The patient was referred to algology department and an intervention on phrenic nerve with pulse radio frequency (8 minutes, 45 Volts, 20 milliseconds wavelength) was performed. Symptoms stopped immediately after the procedure but one week later, although the patient reported a significant decline in symptoms he still had hiccups. The patient was offered oral medical therapy again. With considerable relief from symptoms, the patient accepted oral therapy this time. Gabapentin 300 mg bid was prescribed. The symptoms were completely recovered and the patient reported no hiccups after 30 days of Gabapentin administration. Our case suggests that administration of gabapentin after pulsed radiofrequency might be effective for the treatment of persistent hiccups.

Raoultella ornithinolytica is an encapsulated gram-negative aerobic bacillus belonging to the Enterobacteriaceae family. It is one of the three species of Raoultella. Human infections related to R. ornithinolytica are exceedingly rare. This case report describes an ENT infection caused by R. ornithinolytica successfully treated with antibiotic therapy.