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2017| December | Volume 20 | Issue 12
Online since
January 29, 2018
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ORIGINAL ARTICLES
An evaluation of effects of platelet-rich-fibrin on postoperative morbidities after lower third molar surgery
F Asutay, Ü Yolcu, O Geçör, AH Acar, SA Öztürk, S Malkoç
December 2017, 20(12):1531-1536
DOI
:10.4103/1119-3077.181400
PMID
:29378982
Objectives:
The aim of the present study was to assess whether the use of platelet-rich fibrin (PRF) decreased the pain, swelling, and trismus levels of postoperative third molar surgery.
Materials and Methods:
In a double-blinded, split-mouth randomized study, thirty patients (6 male/24 female, mean age 20.32 years) with bilateral symmetric impacted third molars were enrolled in this study to receive surgery. The PRF mass was randomly placed in one of the extraction sockets, whereas the other socket was left without treatment. The outcome variables were pain, maximum mouth opening (trismus), swelling (edema), and the presence of dry socket which were measured using a 10-point visual analog scale, manual calipers, and 3dMD facial imaging system which was used for the 1
st
time in the third molar surgery.
Results:
Statistical analyses revealed that there were no significant differences between the control and study groups regarding postoperative pain, swelling, and trismus (
P
> 0.05).
Conclusion:
The results of this study suggest that PRF was not observed to have a positive effect on postoperative discomfort, so even though, PRF is presumed to have positive effects on healing and recovery processes.
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6,306
737
Investigation of
In vitro
Mineral forming bacterial isolates from supragingival calculus
O Baris, T Demir, M Gulluce
December 2017, 20(12):1571-1575
DOI
:10.4103/1119-3077.187316
PMID
:29378989
Aim:
Although it is known that bacterial mechanisms are involved in dental calculus formation, which is a predisposing factor in periodontal diseases, there have been few studies of such associations, and therefore, information available is limited. The purpose of this study was to isolate and identify aerobic bacteria responsible for direct calcification from supragingival calculus samples.
Materials and Methods:
The study was conducted using supragingival calculus samples from patients with periodontal disease, which was required as part of conventional treatment. Isolations were performed by sampling the supragingival calculus with buffer and inoculating the samples on media on which crystallization could be observed. The 16S recombinant DNA of the obtained pure cultures was then amplified and sequenced.
Results:
A
few bacterial species that have not previously been associated with mineralization or identified on bacterial plaque or calculus were detected. The bacteria that caused mineralization an aerobic environment are identified as
Neisseria flava
,
Aggregatibacter segnis
,
Streptococcus tigurinus
, and
Morococcus cerebrosus
.
Conclusion:
These findings proved that bacteria potentially play a role in the etiopathology of supragingival calculus. The association between the effects of the identified bacteria on periodontal diseases and calculus formation requires further studies.
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278
Evaluation of accessory mental foramina morphology with cone-beam computed tomography
M Gumusok, ZZ Akarslan, A Basman, O Ucok
December 2017, 20(12):1550-1554
DOI
:10.4103/1119-3077.187329
PMID
:29378985
Background:
Accessory mental foramen (AMF) is the extra mental foramen (MF) located in the mandible. The recognition of AMF is important to avoid complications during surgical procedures involving MF and cheeks.
Aim:
This study aimed to determine the prevalence, localization, and size of AMF by using cone-beam computed tomography (CBCT).
Materials and Methods:
CBCT images of 645 patients over 13-14 years (male 281; female 364) were retrospectively evaluated. The CBCT images were obtained using Promax 3D
®
(Planmeca, Helsinki, Finland) device with automated exposure parameters varying depending on the cases. Statistical analysis was performed using descriptive statistics, chi-square test and
t
-test.
Results:
AMF was detected in 75 (11.6%) patients. There was no significant difference between the presence of AMF and gender (
P
= 0.57,
P
> 0.05). Majority of the cases (
n
= 67, 88.8%) consisted of single AMF, while double AMF was observed in 6 (10%) and triple AMF in 2 (1.2%) patients. The most common location of AMF with respect to MF was posterio-inferior (
n
= 57, 67.1%), and AMF placed at the root line of first molar tooth in 45 cases (52.9%).
Conclusion:
AMF can be seen in the mandible one in every ten patients being single in most cases. Considering the high prevalence and present morphological features, AMF should be detected by CBCT before surgical operations, particularly in implant planning for the prevention of possible complications.
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258
Evaluation of vertical marginal adaptation of provisional crowns by digital microscope
MQ Al Rifaiy
December 2017, 20(12):1610-1617
DOI
:10.4103/1119-3077.196083
PMID
:29378995
Objective:
To investigate and compare the degree of vertical marginal discrepancy of four provisional crown materials by digital microscope.
Materials and Methods:
A total of 100 provisional crowns were fabricated on standardized resin dies by direct technique of provisional fabrication, using four different provisional materials (
n
= 25): Provisionals Fabricated by Systemp
®
c and b II, ivoclar vivadent, Schaan, Liechtenstein (group A); Protemp
TM
Plus, 3M ESPE, Neuss, Germany (group B); Success CD, PROMEDICA, Neumunster, Germany (group C); and Trim
®
Plus, Bosworth Company, Illinois, USA (group D). The provisional crowns were finished, tried, and locked with a customized device under 15N of vertical axial force. The vertical marginal discrepancy between the crown margin and the resin die was measured in micrometers using digital microscope (KH-7700, Hirox-USA, Inc., NJ, USA) at mid of buccal, lingual, mesial, and distal margin areas by a trained technician.
Results:
The mean values obtained for each group were as follows: group A = 129.10 ± 41.64, group B = 123.36 ± 40.94, group C = 89.67 ± 25.34, and group D = 107.24 ± 38.32. Assessment by
post hoc
Tukey's test at 5% significance level showed a statistically significant difference (
P
< 0.05) between group C and group D with the other groups. Results of one-way ANOVA showed a statistically nonsignificant difference (
P
> 0.05) between the means of the four areas of measurement for each group.
Conclusion:
Marginal discrepancy of the group C (Success CD) was the lowest among the provisionals tested. The mean vertical marginal gap values for the materials tested were found to be with in the clinically acceptable range (<130 μm).
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4,349
370
Dentin permeability of carious primary teeth
KG Ulu Güzel, Z Kirzioğlu, S Özkorucuklu
December 2017, 20(12):1566-1570
DOI
:10.4103/1119-3077.196078
PMID
:29378988
Background:
Many
in vitro s
tudies have used dentine permeability to evaluate the efficacy of various restorative and preventative procedures. The easiest way to evaluate dentine permeability is to calculate its hydraulic conductance (Lp) using fluid filtration methods. Research has examined electronic hydraulic conductance measurement methods that give more precise and reliable results for the permeability of dentine than the classical method. To our knowledge, no study has examined the dentine permeability of carious primary teeth.
Aim:
This
in vitro
study determined the dentine permeability of carious primary molars precisely with a new electronic hydraulic conductance measurement system and compared them with healthy primary molars.
Design:
The study examined 60 carious and noncarious primary second molars with no restorations, fractures, or cracks at different root resorption stages.
Results:
The results showed that the dentine permeability increased with the severity of caries in primary teeth.
Conclusion:
The dentine permeability of carious primary teeth was higher than that of noncarious primary teeth. Therefore, treatment of primary teeth should be performed more quickly.
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3,617
236
Evaluation and comparison of mineral trioxide aggregate and biodentine in primary tooth pulpotomy: Clinical and radiographic study
O Carti, F Oznurhan
December 2017, 20(12):1604-1609
DOI
:10.4103/1119-3077.196074
PMID
:29378994
Objectives:
Pulpotomy is the common therapy for cariously exposed pulps in symptom-free primary molar teeth. For many years, researchers have searched for an ideal material that allows regeneration of the residual pulp. The purpose of this study was to evaluate the efficacy of mineral trioxide aggregate (MTA), Biodentine as a pulpotomy medicament in primary teeth, both clinically and radiographically.
Materials and Methods:
A total of 25 children (50 human primary molar teeth) aged between 5 and 9 years were selected in this randomized clinical study. The patients were randomly assigned to receive the pulpotomy medicaments in either [Group 1]: MTA or [Group 2]: Biodentine. All pulpotomized teeth were restored with stainless steel crowns and evaluated clinically and radiologically at 1, 3, 6 and 12 months. Statistical analysis using Mann–Whitney U test and Fisher's exact test, and chi-square test was performed to determine the significant differences between the groups.
Results:
Clinical and radiological success rates were 96 and 80% in Group 1 and 96 and 60% in Group 2, respectively. There were no significant differences between the groups (
P
> 0.05). The radiographic success rates decreased in the controls, but there were no significant differences.
Conclusion:
Biodentine showed similar clinical and radiographic results as MTA in the 12-month evaluation and can be safely used as a pulpotomy medicament.
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8,075
1,193
CASE REPORTS
Bilateral simultaneous macular infarction with spontaneous visual recovery in genotype ss hemoglobinopathy patient
ON Okonkwo, AO Hassan, ME Gyasi, O Oderinlo
December 2017, 20(12):1651-1655
DOI
:10.4103/njcp.njcp_95_17
PMID
:29379002
To report the rare and dramatic event of bilateral macular infarction in a sickle cell hemoglobinopathy (SS genotype) patient, resulting in bilateral severe reduction in visual acuity. Without any intervention, the patient's vision gradually improved over the follow-up period. Central visual field defects however persisted. A 21-year-old male Nigerian, presented with a 1-week history of bilateral sudden painless loss of vision. His symptom was associated with fever, feeling of heaviness in the chest and head, and a dizzy spell. Visual acuity was reduced to 20/200 in both eyes and near acuity was; right eye: N24, left eye: N36. Funduscopy showed a pale, milky white, thickened retinal patch superotemporal to the fovea in both eyes. Fluorescein Angiograph: revealed features consistent with occlusion of the parafoveal terminal arterioles in both eyes. Although he did not receive any ocular treatment, and exchange blood transfusion was not done, he regained near-normal visual acuity in both eyes over a 17-month follow-up period, central visual field defects persisted in both eyes. Visual recovery in this patient demonstrates that macular function could improve over time following macular ischemia, without any treatment. Patients and caring physicians should be aware of this possibility.
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125
Ligneous periodontitis in a child with plasminogen deficiency
U Ertas, N Saruhan, O Gunhan
December 2017, 20(12):1656-1658
DOI
:10.4103/1119-3077.224133
PMID
:29379003
Ligneous periodontitis (LP), a rare periodontal disease, is seen secondary to plasminogen deficiency and fibrin deposition. It is characterized by nodular gingival enlargements and progressive destructive membranous periodontal disease. It generally ends with the early loss of teeth. Defective fibrinolysis and abnormal wound healing is the main pathogenesis of this rare disease and should be considered different from other mucosal systemic disorders. In this case report, we describe the management of ligneous periodontitis and ligneous conjunctivitis developing secondary to plasminogen deficiency in a 6-year-old girl.
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ORIGINAL ARTICLES
Evaluation of apically extruded debris and irrigant using different file systems
B Kütük, KE Akpınar, D Altunbaş
December 2017, 20(12):1555-1560
DOI
:10.4103/1119-3077.196080
PMID
:29378986
Objective:
The aim of this study was to evaluate the amount of apically extruded debris and irrigant during cleaning and shaping with different file systems.
Materials and Methods:
Seventy-five extracted mandibular premolar and canine teeth were randomly divided into five groups (
n
= 15). The root canals were instrumented by using Mtwo (VDW, Munich, Germany), Twisted File (TF; Sybron Endo, Orange, California, USA), Reciproc (VDW), Self-Adjusting File (SAF; Re Dent-Nova, Ra'anana, Israel) systems, and K-type stainless steel hand file (Mani Inc., Tochigi, Japan). Apically extruded debris was collected and dried in preweighed Eppendorf tubes. Extruded irrigant was collected from the cannula by using a plastic insulin syringe. After drying, the amount of apically extruded debris was established by subtracting the initial weight from the final weight of the tubes. After performing the Kolmogorov–Smirnov test, data were analyzed by Kruskall–Wallis test at a significance level of
P
value less than 0.05.
Results:
There were no statistically significant differences between the file systems in terms of debris and irrigant extrusion. Mtwo group produced the highest mean debris extrusion value and the TF group produced the less compared with the other files. The least mean irrigant extrusion value was associated with the SAF group, whereas the highest mean irrigant extrusion value was associated with the Reciproc group.
Conclusion:
Under the conditions of the study, all file systems were associated with apical debris and irrigant extrusion.
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72
Incidence of postoperative residual paralysis in a nigerian teaching hospital
AA Majekodunmi, OA Ikotun, OD Oladokun
December 2017, 20(12):1561-1565
DOI
:10.4103/njcp.njcp_99_17
PMID
:29378987
Background:
Postoperative residual paralysis (PORP) is a known risk factor after general anesthesia (GA) for critical respiratory events and increased postoperative morbidity. PORP is defined as a train-of-four ratio (TOFR) of <0.9 using acceleromyography (AMG). TOFR <0.9 has been associated with increased risk of aspiration, obstruction of the upper airway and an impaired hypoxic ventilatory response.
Aim:
The aim of this study was to determine the incidence of PORP, associated factors related with its occurrence and critical respiratory events in the postanesthesia recovery room (PAR) at our institution.
Methodology:
Forty-one adult patients were scheduled for elective surgeries requiring GA with the use of at least 1 dose of a nondepolarizing neuromuscular blocking drug (NMBD). An independent anesthetist quantitatively measured TOFR of recruited patients postoperatively in the recovery room using the TOF-watch SX acceleromyograph (Organon Teknika) 5 min after arrival.
Results:
The incidence of PORP was 75.6% (
n
= 31), with severe PORP (TOFR <0.7) seen in 41.5% (
n
= 17) of patients. Median time to full recovery in the PAR was 33 min (range 5–164 min). There was no statistical difference in the incidence of PORP related to the choice of NMBD (
P
= 0.186) or duration of surgery (
P
= 0.175). No respiratory complications or events were observed in patients with residual blockade.
Conclusion:
The incidence of PORP is quite high and undetected in our environment. Quantitative monitoring for residual paralysis is advocated as part of routine monitoring with the use of NMBDs for improved patient safety.
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312
Cardiac Troponin T and creatine kinase MB fraction levels among patients with acute ischemic stroke in Nigeria
HM Suleiman, IS Aliyu, SA Abubakar, MS Isa, JM El-Bashir, R Adamu, MZ Ibrahim, A Mohammed, R Yusuf, M Manu, AB Dogara, SK Mustapha, N Bello, SA Ozovehe
December 2017, 20(12):1618-1621
DOI
:10.4103/njcp.njcp_78_17
PMID
:29378996
Background:
Stroke has been a global burden, with increasing morbidity and mortality. Serum cardiac troponin t (cTnT) and creatine kinase (CK-MB) fraction are reported to be elevated in patients admitted with acute ischaemic stroke and high level of these biomarkers indicated more severe stroke and neurologic deficit in some of the patients.
Objective:
To evaluate the serum levels cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) in patients with acute ischaemic stroke and relate the analytes to severity of stroke.
Method:
Patients with clinical diagnosis of ischaemic stroke diagnosed, confirmed by brain Computerized Tomography scan and equal number of apparently healthy age and sex-matched were recruited. Serum cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) were analysed using ELISA method and Stroke severity was determined using National Institute of Health Stroke Score (NIHSS). Results: Mean serum cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) in stroke patients were found to be higher than age sex matched control (p<0.05). NIHS Score of 12.2 ± 5.43 and 9.78 ± 3.97 were observed in Patients with elevated and normal cTnT respectively (p=0.009) while NIHS Score were similar in patients with elevated and normal CK-MB (p = 0.772).
Conclusion:
The mean values of serum cTnT and CK-MB were higher in acute ischaemic stroke patients compared to controls. Serum cardiac Troponin t level may be a significant biomarker of the severity of stroke.
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2,866
274
Ultrasound guided percutaneous nephrostomy: Experience at ahmadu bello university teaching hospital, Zaria
M Ahmed, AT Lawal, A Bello, A Sudi, M Awaisu, S Muhammad, N Oyelowo, M Tolani, BK Hamza, HY Maitama
December 2017, 20(12):1622-1625
DOI
:10.4103/njcp.njcp_138_17
PMID
:29378997
Background:
Obstructive uropathy is a common problem in urologic practice; temporary relief of obstruction in the upper tract poses a significant challenge. Ultrasound-guided percutaneous nephrostomy (PCN) is an option for upper tract drainage; compared to fluoroscopic guidance, it is readily available, affordable, and not associated with radiation exposure. We present our experience with ultrasound-guided PCN.
Patients and Methods:
We studied all patients who had ultrasound-guided PCN in our center between January 2013 and January 2017. Information obtained included the patients' demographics, clinical details, primary pathology, indications, outcome, and complications within 30 days. Relevant data were extracted and analyzed using descriptive statistics.
Results:
A total number of 35 PCNs were performed in 26 patients within the period of study. The median age was 44.5 years. There were 17 females and 9 males. About 88.2% of the females had ureteric obstruction from advanced carcinoma of the cervix while the predominant cause of obstruction in the males was advanced carcinoma of the bladder. Kidney access under ultrasound guidance required well dilated collecting systems for success and ease of puncture. The most common complication was hematuria, which resolved within 24–48 h in all patients uneventfully.
Conclusion:
PCN is an important and common procedure for temporary relief of upper urinary tract obstruction. While fluoroscopic guidance provides superior image guidance, ultrasound guidance is comparatively reliable, albeit with a longer learning curve. Adequate training, careful patients selection, and patience are key to success.
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The efficacy of hyaluronic acid in postextraction sockets of impacted third molars: A pilot study
N Yilmaz, N Demirtas, HO Kazancioglu, S Bayer, AH Acar, A Mihmanli
December 2017, 20(12):1626-1631
DOI
:10.4103/1119-3077.224131
PMID
:29378998
Objective:
This study aims to evaluate the effectiveness of local hyaluronic acid (HA) administration to surgically remove impacted third molar sockets and measure pain, swelling, and trismus.
Materials and Methods:
The study included a total of 25 healthy patients aged 18-29 years with asymptomatic bilaterally impacted lower third molars. All cases have been performed under local anesthesia. In the study group, 0.8% HA (Gengigel
®
) was applied in the postextraction sockets of the right third molars and in the control group nothing was applied to the extraction sockets of the left third molars. Postoperative pain, trismus, and swelling were evaluated on the 1
st
, 3
rd
, and 7
th
postoperative days.
Results:
No difference was determined between groups in facial swelling and maximum mouth opening. However, the amount of pain significantly reduced in HA groups according to visual analog scale (
P
= 0.001).
Conclusion:
The results of this study showed that HA can produce an analgesic action in postextraction sockets after surgical removal of impacted teeth and therefore it has a clinical benefit to reduce usage of nonsteroidal anti-inflammatory drugs after dentoalveolar surgery.
[ABSTRACT]
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631
Normative and subjective need for orthodontic treatment within different age groups in a population in Turkey
RB Nur Yilmaz, I Oktay, D Ilhan, E Fişekçioğlu, Fulya Özdemir
December 2017, 20(12):1632-1638
DOI
:10.4103/1119-3077.224126
PMID
:29378999
Objective:
To evaluate and compare the normative and subjective need for orthodontic treatment within different age groups in Turkey.
Methods:
One thousand and sixteen patients from seven different demographic regions of Turkey (Marmara, Black Sea, East Anatolia, Southeastern Anatolia, Mediterranean, Aegean, and Central Anatolia Region) (mean age
±
SD: 12.80 ± 3.57 years) were randomly selected and divided into six age groups (7–8,9–10,11–12,13–14,15–16, and 17–18 year-olds) and categorized according to the dental health component (DHC) of the index for orthodontic treatment need (IOTN). Additionally, the patients were asked to indicate the photograph that was most similar to their own dentition from the 10-point scale of the aesthetic component of IOTN.
Results:
The DHC of IOTN was not significantly different between the six age groups (
P
> 0.05). However, no/slight need (aesthetic component 1–4) for orthodontic treatment according to AC of IOTN was significantly higher in 13–14,15–16, and 17–18 age groups than 7–8, 9–10, and 11–12 age groups (
P
< 0.05). No sex differences were found in both DHC and aesthetic component of IOTN between age groups (
P
> 0.05).
Conclusion:
The normative need distribution was homogeneous within all the age groups according to DHC. However, the subjective need for orthodontic treatment was higher in the younger age groups.
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Eyelash extension use among female students in a Tertiary Institution in Nigeria: A study of kaduna polytechnic, Kaduna
ER Abah, KK Oladigbolu, AL Rafindadi, O Audu
December 2017, 20(12):1639-1643
DOI
:10.4103/njcp.njcp_124_17
PMID
:29379000
Background:
Eyelash extensions involve the attachment of synthetic eyelashes made of chemical fibers or other materials onto natural eyelashes. It has become common practice among Nigerian women for various reasons.
Aim/Objectives:
The aim is to assess eyelash extension use among students of a higher institution in Nigeria, the reasons for its use and related eye complications.
Materials and Methods:
This is a cross-sectional descriptive study using structured self-administered questionnaire. Stratified sampling technique was used. The key items in the questionnaire were sociodemographic variables, knowledge and use of eyelashes extension, reasons for the use of eyelashes extension and eye symptoms/complications experienced during such use. A total of 310questionnaires were completely and correctly filled. The results were analyzed using SPSS version 23.0 statistical package.
Results:
There were 310 respondents; the age range was 16–52 with a mean of 23.0 years ± 4.8. The prevalence of eyelash use was 38.7%. Beauty was the most common reason for lash extension 56.1% (
n
= 174). Others were curiosity, peer pressure, and replacement therapy. The most common complication was itching 45.8% (
n
= 142). Others were redness, pain, heavy eyelids, loss of lashes, casting of shadow in vision, tearing, burning sensation, foreign body sensation, and boils (stye) on the eyelid.
Conclusion:
Eyelash extension use is popular among young female students of higher institutions commonly for esthetic reasons (often because they desire to become more beautiful). Majority of them experience one ocular symptom or the other. Attention should, therefore, be paid to the potential health risk of the procedure and its use should be made much safer for our women.
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317
Influence of blood contamination during multimode adhesive application on the microtensile bond strength to dentin
E Kucukyilmaz, EU Celik, M Akcay, B Yasa
December 2017, 20(12):1644-1650
DOI
:10.4103/1119-3077.224127
PMID
:29379001
Objectives:
The present study evaluated the effects of blood contamination performed at different steps of bonding on the microtensile bond strength (μTBS) of multimode adhesives to dentin when using the self-etch approach.
Materials and Methods:
Seventy-five molars were randomly assigned to three adhesive groups comprising 25 specimens each: two multimode adhesives [Single Bond Universal (SBU) and All-Bond Universal (ABU)] and a conventional one-step self-etch adhesive [Clearfil S3 Bond Plus (CSBP)]. Each group was subdivided as follows: (1) uncontaminated (control): bonding application/light curing as a positive control; (2) contamination-1 (cont-1): bonding application/light curing/blood contamination/dry as a negative control; (3) contamination-2 (cont-2): bonding application/light curing/blood contamination/rinse/dry; (4) contamination-3 (cont-3): bonding application/blood contamination/dry/bonding re-application/light curing; and (5) contamination-4 (cont-4): bonding application/blood contamination/rinse/dry/bonding re-application/light curing. Dentin specimens were prepared for μTBS testing after the composite resin application. Data were analyzed with two-way ANOVA and post-hoc tests (α = 0.05).
Results:
μTBS values were similar in cont-3 groups, and ABU/cont-4 and corresponding control groups, but were significantly lower in the other groups than in their control groups (
P
< 0.05). Cont-1 groups showed the lowest μTBS values (
P
< 0.05).
Conclusions:
Neither decontamination method prevented the decrease in μTBS when contamination occurred after light curing. Drying the blood contaminants and reapplying the adhesive may regain the dentin adhesion when contamination occurs before light curing. Alternatively, rinsing and drying contaminants followed by adhesive re-application may be effective depending on adhesive type.
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418
Prevalence and correlates of complementary and alternative medicine use among cancer patients in usmanu danfodiyo university teaching hospital, Sokoto, Nigeria
UM Aliyu, KJ Awosan, MO Oche, AO Taiwo, AO Jimoh, EC Okuofo
December 2017, 20(12):1576-1583
DOI
:10.4103/njcp.njcp_88_17
PMID
:29378990
Background
: The rate of complementary and alternative medicine (CAM) use among cancer patients is on the increase worldwide. This is due to the innate urge among humans to try new and alternative ways of medicine, especially where conventional medicine failed to provide satisfactory solution such as in sickle cell disease and cancer.
Objective:
To assess the prevalence and correlates of CAM use among cancer patients in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria.
Materials and Methods:
A
cross-sectional study was conducted among 240 cancer patients selected by systematic sampling technique from July to September 2016. Data were collected using a semi-structured standardized questionnaire.
Results:
The mean age of the study participants was 45 ± 13.7 years. Majority, 159 (66.3%) of the 240 respondents, were CAM users, with the most common methods being prayer (30.8%) and herbal therapy (28.3%). Majority of CAM users (64.2%) did not derive any benefit from CAM use, but rather reported adverse effects such as nausea and vomiting (52.5%) and diarrhea (44.2%). Physicians were unaware of CAM use in most cases (87.4%), and this was majorly attributed to the physicians not asking them about CAM use. Male sex and absence of comorbidities were the predictors of CAM use identified.
Conclusion:
The prevalence of CAM use is high among cancer patients in UDUTH, Sokoto, Nigeria, but the physicians were largely unaware of CAM use due to communication gap. These findings underscore the need for physicians to consistently ask their patients on CAM use, while government should enact laws regulating CAM use in Nigeria.
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Postoperative analgesia using bupivacaine wound infiltration with intravenous tramadol or dexamethasone following obstetric spinal anaesthesia
NP Edomwonyi, MO Osazuwa, OI Iribhogbe, SE Esangbedo
December 2017, 20(12):1584-1589
DOI
:10.4103/njcp.njcp_232_16
PMID
:29378991
Context:
Effective management of postcesarean section (CS) pain is important for the well-being of mother and child; even in limited-resource areas, there are drug options which can be explored to achieve this.
Aim:
This study aimed to compare the analgesic effects of a combination of bupivacaine wound infiltration with either intravenous (IV) dexamethasone or tramadol after CS.
Setting and Design:
This study was a randomized, double-blind, comparative study in a tertiary hospital. Clearance obtained from the Institution's Ethics and Research Committee.
Methods:
One hundred and twenty American Society of Anesthesiologists I or II pregnant women scheduled for CS under spinal anesthesia were recruited after giving consent. At the end of skin closure, all the patients received 20 ml of 0.1% plain bupivacaine for wound infiltration and IV dexamethasone 8 mg (Group BD) or tramadol 100 mg (Group BT). Outcome measures were time to first analgesic request, visual analog scale (VAS) scores, side effects, and patients' satisfaction.
Results:
Time to first analgesic request was 3.2 ± 1.87 and 3.3 ± 2.01 h for BD and BT groups, respectively (
P
= 0.778). VAS scores for the first 2 h were lower in the bupivacaine/tramadol group compared to bupivacaine/dexamethasone group; the differences were statistically significant at 30 and 60 min (
P
= 0.027 and 0.008), respectively. Ninety percent versus 93% of the patients in BD and BT groups, respectively, expressed good to excellent satisfaction with pain relief.
Conclusion:
Combination of bupivacaine wound infiltration and IV tramadol provided better quality pain relief.
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594
Learning transurethral resection of the prostate: A comparison of the weight of resected specimen to the weight of enucleated specimen in open prostatectomy
II Nnabugwu, FO Ugwumba, EI Udeh, OF Ozoemena
December 2017, 20(12):1590-1595
DOI
:10.4103/njcp.njcp_70_17
PMID
:29378992
Background
: Minimally invasive procedures in the surgical management of benign prostate enlargement (BPE) are of limited use in the resource-poor settings due to nonavailability of the requisite facilities and skills. It has been observed that teaching uroendoscopy inclusive of transurethral resection of the prostate (TURP) can be challenging in the resource-poor settings where the traditional master-apprentice (Halstedian) approach has remained the prevalent training technique.
Patients and Methods
: We aimed in this retrospective study to assess completeness of resection in TURP by comparing the proportion of prostate tissue resected to the proportion enucleated in open retropubic prostatectomy (ORP). We included all BPE patients on urethral catheter managed in the first 18 months after Halstedian training in TURP. The analysis was done using SPSS
®
20 and VassarStats
®
online software.
Results
: Twenty patients' files for TURP and twenty-eight patients' files for ORP met the inclusion criteria. Patients in the 2 treatment arms were similar in age (
P
= 0.22), body mass index (
P
= 0.45), proportion of prostate tissue extirpated (
P
= 0.38), and International Prostate Symptom Score 12-month postprocedure (
P
= 0.06). However, larger prostates were treated with ORP (
P
< 0.0005). The correlation of the weight of resected specimen to preoperative prostate volume (PV) (
r
= 0.78;
P
< 0.001) was similar to that of enucleated specimen to preoperative PV (
r
= 0.89;
P
< 0.001). Similarly, the proportion of extirpated specimen correlated positively with the preoperative PVs for both TURP (
r
= 0.23;
P
= 0.33) and ORP (
r
= 0.292;
P
= 0.13), with no evidence of any difference between the 2 correlation values (
P
= 0.84).
Conclusion:
With appropriate patient selection, especially as a newly trained Surgeon, resections in TURP are as complete as enucleations in ORP.
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1,879
172
Heat-cured acrylic resin versus light-activated resin: a patient, professional and technician-based evaluation of mandibular implant-supported overdentures
SA Asal, HM Al-AlShiekh
December 2017, 20(12):1596-1603
DOI
:10.4103/1119-3077.196082
PMID
:29378993
Context:
Although light-activated resins (Eclipse) have been reported to possess superior physical and mechanical properties compared with the heat-cured acrylic resins (Lucitone-199), a few studies have compared overdentures with a locator attachment constructed from heat-cured acrylic resins with those constructed from light-activated resins.
Aims:
This clinical study was designed to compare the performance of a mandibular implant-supported overdenture constructed from a heat-cured acrylic resin (Lucitone-199) with that of an overdenture constructed from a light-activated resin (Eclipse).
Materials and Methods:
Ten participants received two identical mandibular implant-retained overdentures (Lucitone-199 and Eclipse) opposing one maxillary denture in a random order. Each mandibular overdenture was delivered and worn for 6 months, and two weeks of rest was advised between wears to minimize any carryover effects. Three questionnaires were devised. The first questionnaire (patient evaluation) focused on evaluating different aspects of the denture and overall satisfaction. The second questionnaire (professional dentist evaluation) was based on a clinical evaluation of soft tissues, complications, and the applied technique. The third questionnaire (technician evaluation) involved ranking the different manufacturing steps of the denture and overall preferences. The obtained data was statistically analyzed using an independent sample t-test and the Wilcoxon rank-sum test.
Results:
The clinician and technician preferred the Eclipse dentures because of their technical aspects, whereas the patients preferred the Lucitone-199 dentures for their aesthetic properties.
Conclusions:
Implant-supported overdentures constructed from a heat-cured acrylic resin showed superior aesthetics and had a better odor compared with those constructed from a light-cured resin.
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8,097
362
Time interval to initiation of contraceptive methods following childbirth in a low-resource setting
A Mohammed-Durosinlorun, J Adze, S Bature, A Abubakar, C Mohammed, M Taingson, A Ojabo
December 2017, 20(12):1537-1543
DOI
:10.4103/njcp.njcp_259_16
PMID
:29378983
Objectives:
The objectives of the study were to determine factors affecting the interval between a woman's last childbirth and the initiation of contraception.
Materials and Methods:
This was a retrospective study. Family planning clinic records of the Barau Dikko Teaching Hospital Kaduna from January 2000 to March 2014 were retrieved. Information was collected on demographics, reproductive, and contraceptive history. Data were analyzed using the SPSS version 15 software, and missing responses were excluded. Chi-square was used as a test of association with significance level established at
P
= 0.05.
Results:
A
total of 5992 client's cards were retrieved. All were female and married. Majority were aged 25–34 years (53.1%), had completed secondary education (56%) and were Muslims (52.3%). Only 4979 cards (83.1%) had correct data on intervals and 22.1% of these clients initiated contraception within 6 months of their last childbirth. Education, religion, source of information, number of living children, desire to have more children, previous use of contraception, and type of contraception chosen were significantly associated with intervals for initiating contraception after last childbirth (
P
< 0.05) while the presence of complications in the last delivery was not (
P
> 0.05).
Conclusions:
Majority of women initiate contraception late after childbirth in this setting. Increased awareness on immediate/early postpartum contraception is required. Further qualitative studies will help to explore findings of this study.
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233
Risk factors for diabetes mellitus among adult residents of a rural District in Southern Nigeria: Implications for prevention and control
GM Arugu, O Maduka
December 2017, 20(12):1544-1549
DOI
:10.4103/njcp.njcp_154_17
PMID
:29378984
Introduction:
Diabetes Mellitus is a non-communicable disease that affects people worldwide and poses major public health and socioeconomic challenges.
Methods:
This was a descriptive cross-sectional community based survey carried out in Abua, a rural district located in the Niger Delta region of Nigeria among 462 adults recruited through multi-stage sampling. Data was collected using the structured WHO STEPS instrument for Chronic Disease Risk Factor Surveillance. The questionnaire included questions that assessed socio-demographic characteristics, diabetic risk factors, anthropometric measures, and biochemical parameters. Fasting blood glucose and blood pressure was measured using the WHO recommendations.
Results:
Equal number of males and females aged between 18 and 82 years were recruited. Mean age of 40.4614.36 years and median age of 38.5 years. The prevalence of diabetes mellitus was 37 (8.0%), of which 28 (6.1%) were previously diagnosed while 9 (1.9%) were newly diagnosed. Alcohol intake (AOR = 10.69; 95% CI = 2.60-43.87;
P
= 0.001) physical activity (AOR = 4.78; 95% CI = 1.16-19.65;
P
= 0.03), diastolic blood pressure (AOR= 32.67; 95% CI = 3.68-289.65;
P
= 0.002), age and family history of DM showed significant independent association (OR 1.09, 95% CI: 0.000,
P
< 0.001, OR 0.072, 95% CI: 0.014–0.380,
P
= 0.007) with diabetes mellitus.
Conclusion:
Study findings underscore the need for diabetes prevention and control activities that address the four major risk factors identified by WHO. These interventions will positively impact prevalence of diabetes and other NCDs. Intervention strategies should not only target urban populations but also focus on education and health promotion among rural populations in a bid to forestall rising prevalence of diabetes.
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6,967
672
The translucency effect of different colored resin cements used with zirconia core and titanium abutments
N Capa, C Celebi, A Casur, I Tuncel, A Usumez
December 2017, 20(12):1517-1521
DOI
:10.4103/njcp.njcp_160_17
PMID
:29378979
Purpose:
The purpose of this study was to evaluate the effect of the different color of resin cements and zirconia cores on the translucency parameter (TP) of the restoration that simulates the implant-supported fixed prosthesis using titanium base on the bottom.
Materials and Methods:
Zirconia core plates (Zr-Zahn) were prepared in A2 shades (
n
= 11). Resin cement plates (3M ESPE) were prepared in A2, A1, translucent (TR) shades (
n
= 11). The initial color measurements and were measured on zirconia core plates, and resin cements plates using a spectrophotometer. Then, the resin cement plates were placed below the zirconia core plates, and the second measurements were done. The final measurements were done after placing the titanium discs in the bottom. The data were analyzed with two-way analysis of variance and Tukey honestly significant differences tests (α = 0.05).
Results:
The highest TP values were recorded for A1-colored resin specimens and the lowest for zirconia core plates in the first measurement (
P
< 0.05). The addition of zirconia core decreased the TP values in all tested resin cement groups (
P
< 0.05). The highest TP value was recorded for A1-colored resin cement with zirconia core plates and the lowest for A2 and TR with zirconia core plates after second measurements (
P
< 0.05). The addition of titanium decreased the TP of the zirconia core plate and resin cement combination (
P
< 0.05).
Conclusions:
The addition of a zirconia core under the resin cement dramatically reduced the TP values, and the presence of a titanium layer decreased the TP value and caused a darker appearance.
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1,333
The prevalence of osteoporosis among antenatal clinic attendees in a rural mission hospital in South-East Nigeria
PO Ezeonu, UM Agwu, LO Ajah, IB O Dimejesi, LU Ogbonnaya, OU J Umeora, RC Onoh
December 2017, 20(12):1522-1526
DOI
:10.4103/njcp.njcp_267_16
PMID
:29378980
Introduction:
Osteoporosis is a global public health problem characterized by reduction of bone mineral density (BMD). This study aimed to assess the prevalence of osteoporosis among antenatal clinic attendees in a rural Southeastern hospital.
Material and Methods:
This was a cross-sectional study of booking Antenatal Clinic Attendees at Mile 4 Catholic Hospital, Abakaliki, between October 2014 and February 2015. The study participants were selected through systematic random sampling. The BMD of the right calcaneal bone of the participants was measured using the OsteoPro, a Quantitative ultrasound scan.
Results:
A
total of 327 eligible women participated in the study. The average age of the participants was 29 ± 4.5 years. The average parity was 2 ± 1.6 childbirths. The mean
T
-score was −1.19 ± 4.9. Osteoporosis and osteopenia were recorded in 119 women (36.4%) and 56 women (17.1%), respectively, whereas 152 (46.5%) were within normal range. History of regular exercise by the respondents is statistically significant on the reduction of osteopenia and osteoporosis (
P
≤ 0.05). The history of ever use of calcium supplementation by the study participants in the index pregnancy did not have any significant effect on the reduction of osteoporosis.
Conclusion:
There is a high prevalence of osteoporosis among pregnant women in Southeast Nigeria. This may be due to the predominant poor adherence and low dose of calcium supplementation among pregnant women in this environment. Therefore, there is an urgent need for sensitization on this public health problem.
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3,377
295
Evaluation of antimicrobial and thermal effects of diode laser on root canal dentin
BH Kivanç, HD Arisu, BC Saglam, G Akca, MA Gurel, G Gorgul
December 2017, 20(12):1527-1530
DOI
:10.4103/1119-3077.187333
PMID
:29378981
Objectives:
The aim of this study was to evaluate the antimicrobial effects of diode laser and temperature rise on the root surface during application.
Materials and Methods:
Thirty-six teeth were chemomechanically prepared and irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid, and then autoclaved and incubated with a suspension of
Enterococcus faecalis
. The specimens were randomly divided into three groups (
n
= 12): Group 1, irradiated by diode laser at 1.2 W; Group 2, irradiated by diode laser at 2 W; and Group 3, irradiated by diode laser at 3 W. The grown bacteria were counted and the mean numbers of the each test tube were determined. The temperature was measured on the external apical third of the root during laser application. The mean values of results for each group were compared using one-way analysis of variance and Tukey test.
Results:
No significant difference was obtained among the test groups in terms of the colony counts (
P
> 0.05). According to the temperature changes, there was a significant difference between groups (
P
< 0.05). Temperature rises were 16.79°C, 10.20°C, and 6.25°C in Group 3, Group 2, and Group 1, respectively.
Conclusion:
Diode laser irradiation with 1.2 W demonstrated comparable performance with 2 W and 3 W power sets for elimination of
E. faecalis
from root canal with less temperature rise.
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Online since 10
th
November, 2010