Objective: The aim of this study was two-fold: (1) To assess the incidence of dental pulp stone formation during orthodontic treatment, and (2) to determine the correlations between the presence of dental pulp stones and age, gender, and dental arches. Materials and Methods: A sample of 545 patients (334 girls and 211 boys, age range; 12–22 years) who had undergone nonextraction orthodontic treatment were included in this study. 8442 teeth (T1) and 8410 teeth (T2), including the first and second maxillary and mandibular premolars and molars were evaluated from the pre- (T1) and post-treatment (T2) panoramic radiographs of the patients. The Pearson Chi-square test was used to investigate the associations between the presence of dental pulp stone, gender, age, tooth type and arches. Results: Dental pulp stones were detected in 3% of the teeth at pretreatment panoramic radiographs and 5.2% of the teeth at posttreatment panoramic radiographs. Pulp stone prevalence increased pointedly (2.2%) in the pre- and post-treatment radiographs (P < 0.001). Also, there was a significant difference between the age groups (P < 0.001). In the maxilla, dental pulp stones were found significantly more than that in the mandible at T1 and T2 panoramic radiographs. Maxillary first molars exhibited dental pulp stones the most frequently, followed by the maxillary second molars and mandibular first molars. Conclusion: Orthodontic treatment may trigger the formation of dental pulp stones. However, further studies are required to determine the relationship between the pulp stone formation and orthodontic treatment.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Introduction: Mental foramen (MF) locations were determined according to gender and age in terms of the vertical distance from the surrounding anatomical structures and the vertical and horizontal size of the MF. Materials and Methods: One hundred-seven male and 103 female patients in the age group between 10 and 70 years were included in our retrospective study and were examined using cone-beam computed tomography (CBCT). The right and the left MF locations were determined from panoramic and cross-sectional images. On the cross-sectional CBCT images, the distance of the MF upper limit from the alveolar crest edge, the distance of the MF lower limit from the lower edge of the mandible, and vertical size of the MF were measured. Results: MF location differed in males and females (P < 0.001); it was generally located at the first and second premolar in females, and at the level of the second premolar in males. However, the MF location was not different on the right and left sides (P = 0.436). The distance of the MF from the surrounding anatomic structures were found to be lower in females than in males in all measurements (P < 0.001). The horizontal size of the MF was found to be less on the left side (P < 0.001). Conclusions: Knowing both the position and the distance of the MF from the surrounding anatomical structures is not only useful information for surgery, but will also help avoid complications such as paresthesia.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

The use of information and communication technology for health care delivery, particularly in poor settings where access to medical services is inadequate, holds promise in expanding health care access. In rural or impoverished environment, where disease is prevalent, doctors are scarce, and health care infrastructure is inadequate, telemedicine holds a good prospect in improving the health conditions of the people. However, telemedical practice in Africa cannot be without challenges because some aspects are often difficult to implement in underdeveloped settings where ignorance and poverty are rife. Apart from nonavailability of facilities and poor communication, most Africans have different understanding of ailments, which often affect the health system. Considering the increasing disease burden in Africa and the need for tremendous progress in achieving the health component of the millennium development goals, telemedicine should be of concern to health policy makers. This paper critically examines the prospects and challenges of telemedical practice in Africa through a systematic review of 31 relevant publications which, in addition to the authors' knowledge and experience in biomedical care in Africa, supported the information as presented.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Context: The concept of burnout is an important element for efficiency in occupational groups such as health and education, which necessitate constant communication with people and have a busy schedule. Aims: The determination of the levels of burnout syndrome, organizational commitment, and job satisfaction of the health workers. Materials and Methods: A questionnaire consisting of four parts was prepared so as to measure the levels of organizational commitment, job satisfaction, and burnout of the medical staff of the institution. The data for this research were gained by a questionnaire sent to 370 medical staff (doctors, nurses, contract staff, and other employees). Statistical Analysis Used: Kolmogorov Smirnov test, t-test, ANOVA, Tukey multiple comparison test and Pearson's correlation analysis were used to this study. Results: The average age of the employees taking part in the questionnaire was calculated as 34.30 years (min: 18 years, max: 59 years). The proportional value of the individuals with their 0-5 years working period in the institution was observed as 58.1%. An individual's interior work satisfaction, education level, hours worked at the hospital and their titles are also statistically important (P< 0.05). There is a positive correlation and significant relation between medical staffs' emotional exhaustion and desensitization (r = 0.573). There is a positive correlation and significant relation between normative commitment sub dimension, interior and exterior job satisfaction (r = 0.449, r = 0.472). Conclusions: Efforts to reduce the job burnout and psychological support for health care workers support motivation in order to provide better services to increase significantly. Thus, both personal productivity will be increased, and gain will be obtained in the institutional sense.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Objective: Obesity is a major public health problem and great risk for not only cardiovascular diseases but also cancer, musculoskeletal, and gynecological diseases. This study was aimed to investigate the association between serum Vitamin B12 (vitB12), body mass index (BMI), and nutritional status among obese women. Methods: This cross-sectional study enrolled consecutive female subjects. The consumptions of red meat, fish, bovine liver, egg, and mushroom were recorded. According to the Dietary Reference Intakes, the patients were categorized as insufficiency and sufficiency. Three cutoff points were defined for vitB12 status: (1) Deficiency if vitB12 is <200 pg/mL; (2) insufficiency if vitB12 is 250–350 pg/mL, and (3) sufficient if vitB12 is ≥350 pg/mL. According to BMI, the patients were assigned to nonobese and obese groups. BMI, serum vitB12 level, consumptions of red meat, fish, bovine liver, egg, and mushroom were evaluated and compared between two groups. Results: Mean level of vitB12 was 247.8 ± 10.4 pg/mL and significantly associated with consumption of egg (P = 0.031), bovine liver (P = 0.004), mushroom (P = 0.040), and red meat (P = 0.003). VitB12 was significantly higher in nonobese than obese group (282.5 ± 106.8 vs. 242.5 ± 107.5 pg/mL, P = 0.001). The ratio of vitB12 deficiency was significantly higher in obese than nonobese group (37.6% vs. 24.7%; P = 0.019). VitB12 level was negatively correlated with BMI (r = −0.155; P< 0.001), but not insulin resistance (r = −0.172; P = 0.062). Conclusion: Obesity was associated with low level of vitB12 in obese women, and more likely to be vitB12 deficient. Consumption of certain types of food contributes to increase vitB12 level.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Background: Physical growth of a child is a reflection of its state of nutrition. In some developing countries such as Nigeria with changing economy and rapidly growing population, the nutritional status of the children is a reflection of the general well-being of the society. Materials and Methods: This was a descriptive cross-sectional study in which participants were selected using a multistage sampling method. Heights and weights of randomly selected school children aged 6–12 years were measured using standard protocols. Weight-for-age, height-for-age, and body mass index (BMI)-for-age expressed as Z-scores were used to characterize the nutritional status. Descriptive statistics was used to determine the frequency and standard deviations (SDs) of the anthropometric measurements. Age and gender differences in the mean body weight, height, and BMI were evaluated using an independent samples t-test. Significant levels were set at P< 0.05. Results: A total of 1305 males and 1311 females were enrolled in the study. The mean age was 8.9 ± 1.9 years. Their mean height, weight, and BMI were 136.6 ± 10.2 cm, 29.7 ± 7.7 kg, 15.7 ± 2.4 kg/m², respectively. Their mean ± SD scores of the WAZ, HAZ, and BAZ were 0.33 ± 1.20, 0.78 ± 1.17, and − 0.51 ± 1.27, respectively. A majority (78.9%, 2090/2616) were in the normal growth category. Wasting, overweight, obesity, underweight, and stunting were noted in 9.3% (243/2616), 6.3% (166/2616), 4.4% (117/2616), 0.9% (26/2616), and 0.4% (13/2616) of the children, respectively. Wasting was more in males (P = 0.069), and overweight was more in females (P = 0.138). Conclusion: A majority of the children have normal growth with the remainder in both extremes of malnutrition. Institution of school-feeding programs in all Nigerian schools as well as nutrition education/campaign directed at parents and their children will help forestall the double burden of under- and over-nutrition among our children.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Objectives: The purpose of this study was to analyze and evaluate a Turkish translation of the oral health impact profile-14 (OHIP-14) in a Turkish population to provide an objective standard for future studies. Methods: This cross-sectional research study consisted of three independent studies. Data were collected utilizing a personal interview and a review of periodontal records. This study was performed on 1205 subjects who were visiting for routine medical check-ups. The OHIP-14 was administered to measure oral health related to the quality of life, along with a questionnaire addressing demographic information, such as age, gender, and education. Results: The reliability coefficient (Cronbach's alpha) of the Turkish version OHIP-14-TR (OHIP-14-TR) was reported to be nearly perfect in all 3 parts of our study (alpha 1: 0.82; alpha 2: 0.76; alpha 3: 0.91); additionally, values were greater than the recommended 0.70 threshold. Spearman's correlation coefficients showed that both OHIP scores significantly correlated with periodontal parameters, serving as proof of convergent validity (P < 0.01, P< 0.001). The principal component analysis with varimax rotation revealed seven factors. The OHIP-14-TR was more than 95% comprehensible. Conclusion: The OHIP-14-TR is a reliable, valid, and comprehensible scale for measuring oral health-related quality of life in the Turkish population.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Background: The ponticulus posticus (PP; Latin for little posterior bridge) has become an important anomaly of the atlas, as the use of the C1 lateral mass screw has become common in treating atlantoaxial instability. Aim: The purpose of this study was to retrospectively determine the prevalence and morphologic characteristics of PP in an orthodontic patient population using cervical three-dimensional (3-D) cone beam computed tomography (CBCT) images. Material and Methods: A retrospective study was conducted by selecting cervical 3-D CBCT images of 374 adolescent population and examining them for the presence and type of PP. Results: 161 patients with 298 complete or partial or bilateral or unilateral PPs were identified based on the 374 cervical 3-D CBCT scans. The prevalence of posticulus ponticus was founded 43.04% in adolescent population. Conclusion: Our results show that the presence of this anomaly should be carefully examined using preoperative lateral radiographs before lateral mass screw placement. If a PP is suspected or confirmed on radiographs, 3-D CBCT scanning should be considered before lateral mass screw placement into the posterior arch because of the variation in the size and shape of PPs and the possibility of injury.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Aims: Zoonotic diseases, which are a major public health problem in our city, have a negative impact on public health and also cause economic losses due to yield losses of animals and deaths. This study was carried out to determine the seroprevalence of tularemia, bartonellosis, brucellosis, Q fever, and cystic echinococcosis in the risk groups for zoonotic infection. Subjects and Methods: Ninety serum samples were taken from people in the risk groups in covering veterinarian, butchers, farmers and examined with the following tests: Microagglutination test for tularemia, indirect fluorescent antibody test (IFAT) for bartonellosis, standard tube agglutination test for brucellosis, IFAT IgG for Q fever, and enzyme-linked immunosorbent assay IgG test for cystic hydatid. Statistical Analysis Used: The Chi-square analysis was used to assess, and the logistic regression analysis was used to identify the risk factors. Results: The analyzed all serum samples were found to be seronegative for tularemia, bartonellosis, and hydatid cyst antibodies. When analyzed for Coxiella burnetii with IgG antibody titers, it was determined that 23 samples (25.6%) were seropositivity. When brucellosis was analyzed with serological tests for Brucella, it was positive in seven samples (7.8%). Conclusions: In this study, examined in the risk groups in which it is located along black sea coast of Turkey for tularemia, bartonellosis, and hydatid cysts, seropositivity was not found. When Brucella was tested, 7.8% was found to be positive, and when analyzed in terms of Q fever, 25.6% of people were determined to be seropositive. In conclusion, in our region, Q fever seropositivity was found to be higher in the risk groups. Therefore, most of the zoonotic disease look like not so common in the region, out of tularemia.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Background: This study describes the epidemiology and clinical features of hepatocellular carcinoma (HCC), and it investigates any association between Child-Pugh's classification and HCC. Materials and Methods: A retrospective chart review was performed for HCC cases diagnosed between 2008 and 2014 at King Abdulaziz University Hospital. We documented the age at cancer diagnosis, gender, occupation, ethnic origin, HCC etiology, Child-Pugh scores, tumor characteristics, alpha-fetoprotein (AFP), and alkaline phosphatase (ALP) levels at diagnosis, and treatment administered. The Chi-square test was used to determine differences between categorical variables. Results: We included 128 patients. Hepatitis B and C viral infections were documented in 24.2% and 33.6% of the patients, respectively. Patients with tumors >5 cm were more likely to have Child's Class C disease, whereas those with tumors ≤2 cm were more likely to have Child's Class A (P < 0.001). Similarly, patients with bilobular or metastatic tumors were more likely to have Child's Class C disease (P = 0.001 and 0.002, respectively). No difference in Child-Pugh score was found between patients with single or multiple tumors (P = 0.480). Furthermore, patients who were both hepatitis B and C positive were more likely to have Child's Class C disease (P = 0.018). Likewise, those who had abnormal AFP and ALP levels ≥1000 ng/mL were more likely to have Child-Pugh's Class C liver disease (P = 0.021 in both cases). Conclusion: Hepatitis C and B infections were the main risk factors associated with HCC.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Background: Human immunodeficiency virus (HIV)-infected pregnant women have alterations in cellular and humoral immunity that increase the risks to placental malaria infection. Aim: This study aimed at determining the prevalence and predictors of placental malaria among HIV-positive women in Nigeria. Materials and Methods: It was a longitudinal cohort study of pregnant women receiving antenatal care at a tertiary hospital in Nigeria. Peripheral blood sample for packed cell volume estimation and placental blood sample for malaria parasite estimation were collected from each participant at a presentation in labor and upon delivery, respectively. Results: The Prevalence of placenta malaria (68.6%) and anemia (66.7%) in HIV-positive women were significantly higher than the prevalence of placental malaria (35.3%) and anemia (44.1%) in HIV-negative control (P < 0.001 and P = 0.001 respectively). The employment status was the only sociodemographic factor significantly associated with the development of placental malaria in HIV-positive women (odds ratio: 21.60; 95% confidence interval: 7.1–66.2; P< 0.001). Conclusion: The prevalence of placental malaria is very high among HIV-positive women in Nigeria. Scaling up free distribution of insecticide treated nets in the short term and employment opportunities of HIV-positive women, in the long run, may reduce the prevalence of placental malaria in our population.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Introduction: Flexible fiberoptic bronchoscopy (FOB) is a key diagnostic and therapeutic procedure in pulmonology. Experience with fiberoptic bronchoscopy is scanty in most developing countries. Objectives: The goal of this study was to report our experience and clinical utility of fiberoptic bronchoscopy. Methods: A review of bronchoscopy requests, services, and reports performed over a 5-year period was performed. Demographic characteristics were extracted. Indications for the procedures, type of bronchoscopic sampling done, final diagnosis, and complications were reported. Sensitivities, specificities, and overall diagnostic yield of the procedures were determined. Results: About 163 diagnostic bronchoscopies were performed during the study. Ninety-nine patients with complete data were analyzed. Mean age was 54.8 ± 19.2 years, with males constituting the majority, 56.6%. Suspected bronchial cancer and pleural effusion were the main indications for bronchoscopy (33% and 19.1%, respectively). A total of 80, 39, and 99 bronchial washings, brushings, and bronchial biopsies were performed, respectively. Bronchial cancer was confirmed in 51.5% and was diagnostic in 57% of suspected pleural effusion. Pulmonary tuberculosis was confirmed in 50% of suspected cases and additional 8 cases were diagnosed. The overall diagnostic yield of bronchoscopy was 62%. Specificities of bronchial brushing and washing cytology for excluding bronchial cancer were 90.9 and 83%, respectively, and sensitivities of detecting bronchial cancer were 64.3% and 59%, respectively, P< 0.05 each. Serious complication occurred in about 1%. There was no mortality. Conclusions: These results show that FOB is a useful and safe procedure with a low complication rate in our setting.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Background: The FluoreCam system is based on an innovative approach to the quantification of enamel health termed fluorescence enamel imaging (FEI). Enamel is both highly mineralized and semi-translucent. Because of its mineral composition, enamel will fluoresce when exposed to certain light wavelengths. The semi-translucent nature of enamel results in different enamel densities emitting different levels of fluorescence. As a result, with FEI technology, one can measure the density of tooth enamel by measuring its fluorescence when subjected to specific light wavelengths. Purpose: To determine the ability of visual examination and the instrumental procedures of the FluoreCam to monitor molar-incisor hypomineralization (MIH) lesions. Subjects and Methods: This study involved children with MIH at the Department of Paediatric Dentistry, Marmara University. In total, 11 patients with MIH were diagnosed on a visual MIH scale and evaluated with the FluoreCam. The equipment, data processing, and interaction between the equipment and operator were evaluated. Results: Fluorescent images recorded with the custom software, the clinical view, and digital numeric values were evaluated to assess the potential for use of the device in clinical practice. Conclusion: These preliminary data from an ongoing clinical study suggest that measurements with the FluoreCam are useful in monitoring MIH. This technique also provides visual and quantitative feedback to patients.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Background: Inadequate skilled manpower at rural posts is a serious impediment toward equitable and universal access to healthcare in Nigeria. Objective: To examine the experiences of primary health care (PHC) workers on rural assignments, requests for transfer, and perspectives about critical factors for retention of healthcare workers at rural posts. Materials and Methods: Using descriptive cross-sectional design, 262 PHC workers in Kano were studied. Data were collected using semi-structured questionnaires and analyzed on Statistical Package for Social Sciences version 22. Pearson's Chi-square and Fisher's exact tests were used to test for significant association between categorical variables. P ≤ 0.05 was considered significant. Results: The mean age of the workers was 36.0 ± 9 years. Majority were females (55.4%) and married (64.2%) with mean working experience of 13.0 ± 8.0 years. Only 29 (11.2%) had rural posting experience. Mean duration of posting was 4.0 ± 2.0 years; 19 (65.5%) sought re-deployment for lack of social amenities and good schools for children 19 (100.0%) and poor work environment 17 (89.5%). Common positive rural experiences mentioned were less work pressure 26 (89.7%), cordial relationship with colleagues and community members 24 (82.8%), and willingness of the community to partake in health activities 24 (82.8%). Common negative experiences reported include lack of social amenities 27 (93.1), lack of equipment and supplies in facilities 26 (89.7%), and stagnation 22 (75.9%). The workers' perspectives about critical factors for retention at rural posts include good facility infrastructure and functional equipment 240 (92.3%), good housing 237 (91.2%), potable water and electricity supply 238 (91.5%), good schools for staff's children 38 (91.5%), and good access of road to town 239 (91.9%). Conclusion and Recommendation: While steering gear at upgrading basic infrastructures in rural areas, government should in the interim, ensure attractive working and living conditions at rural posts.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

We report a case of rudimentary horn pregnancy at 12 weeks gestation with fetal demise misdiagnosed ultrasonographically as an intrauterine pregnancy in a private clinic. The patient was referred to a tertiary care hospital after failed attempts at terminating her pregnancy. A definitive diagnosis was made with ultrasonography and magnetic resonance imaging (MRI) before uterine rupture ensued. Excision of the rudimentary horn and the ipsilateral fallopian tube was carried out by laparotomy. Failure to terminate pregnancy after several attempts should alert the physician about the possibility of a uterine anomaly and a pelvic MRI scan may help in the diagnosis of a suspected rudimentary horn pregnancy.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Aim: To compare genetic aberrations in the oral epithelium of lung cancer patients with those without cancer. Subjects and Methods: Buccal smears were performed to collect oral epithelium from each of the participants (smoker cancer patients n = 50, smoker control subjects n = 40, and nonsmoker control subjects n = 25). Cytogenetic changes in the samples were detected by micronuclei assay, whereas p53 and murine double minute 2 (MDM2) polymorphisms were genotyped using polymerase chain reaction-restriction fragment length polymorphism. Results: p53 codon 72 polymorphism was seen in 44% of cancer patients versus 12.5% in smokers and 12% in nonsmokers of the control group. Similarly, MDM2 single nucleotide polymorphism 309 polymorphism was seen in 34% of patients with lung cancer as opposed to 12.5% of smokers (P = 0.038) and 8% of nonsmokers (P = 0.019) of the control group. Conclusion: A higher proportion of individuals with lung cancer demonstrate genetic damage to oral mucosa compared to those without cancer.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Background: Fever is a very common problem in pediatric age and is one of the most common reasons parents seek medical attention. We aimed to investigate beliefs, habits, and concerns of Turkish parents regarding their children's fever. Materials and Methods: We performed a cross-sectional survey which was conducted as face-to-face interviews by family physicians from April to June 2014 in family healthcare centers in nine different cities in Turkey. Parents with a child with fever aged between 0 and 14 years were interviewed. The participants were asked questions about sociodemographic data, the definition and measurement of fever, antipyretics, and other interventions used to reduce fever before presenting to the primary care center. Results: A total of 205 parents participated in this study. Ninety-four parents (45.8%) measured fever with a thermometer prior to presentation. Only 36 parents (38%) used the thermometer correctly. Thirty-eight parents (18.5%) knew the correct temperature definition of fever for the measured site. A mercury-in-glass thermometer was the choice for most parents (78%) and preferred site for measurement was axillary region (85%). The fever was treated prior to arrival by 171 parents (83.4%). Paracetamol was the most frequently used antipyretic. Fifty-four parents (31.5%) failed to administer the correct antipyretic dose, and 73 parents (42.6%) failed to give the antipyretics at proper intervals. One hundred and fifty-three parents (67%) believed that if not treated fever could cause convulsions. Conclusion: We conclude that parents share important misconceptions about definition, treatment, and consequences of childhood fever and tend to treat fever before seeking medical care with a substantial rate of wrong doses and wrong intervals.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Idiopathic thrombocytopenic purpura (ITP) is an acquired thrombocytopenia without other clear cause of thrombocytopenia. It is not common in a singleton pregnancy and less common in twin pregnancy. We report a 33-year-old ITP pluripara whose first pregnancy was uneventful. She carried twin pregnancy, complicated by recurrent very low platelets, and gave birth to preterm twins. This patient received multiple courses of intravenous immunoglobulin (IVIG) and showed a significant platelet count improvement with IVIG therapy.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Acute hyperkinesia after discontinuation of tramadol in a patient with chronic pain using citalopram and pramipexole for restless legs syndrome (RLS) has not been reported. An 81-year-old female was admitted for increasing hyperkinesias of the whole body after she had discontinued tramadol 300 mg (taken during 3 months) without tapering 4 days earlier. In addition, she was on treatment with pramipexole (0.18 mg) for RLS for years, citalopram 10 mg/day for ~4 years, and fentanyl 75 μg/day for 1 year. Hyperkinesias did not respond to benzodiazepines, quetiapine, biperiden, or valproic acid. Surprisingly, hyperkinetic bursts resolved immediately upon 15 mg fentanyl intravenously. Obviously, tramadol withdrawal had enhanced the preexisting RLS. Overdosing of pramipexole or serotonin syndrome was excluded. Sudden discontinuation of tramadol in a patient under pramipexole for RLS may cause severe, choreatic hyperkinesias for hours, which immediately resolve upon intravenous fentanyl. In patients under pramipexole for RLS and tramadol and fentanyl for chronic pain, sudden discontinuation of tramadol should be avoided to prevent induction of restless body syndrome.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Background: The germ tube test (GTT) is inexpensive, easy, and well-defined test that differentiates Candida albicans (excluding Candida dubliniensis and Candida africana) from other species. The aim of this study was to evaluate various serums (i.e., human, rabbit, horse, and fetal bovine serum) used in the GTT and Mueller-Hinton agar (MHA). Materials and Methods: Fifty species isolated from various clinical samples that were defined as C. albicans by both conventional and DNA sequence analysis methods were included in the study. One to two colonies of C. albicans were mixed into 0.5–1 ml of fetal bovine serum, horse serum, rabbit serum, and human serum. Serums and MHA were incubated at 37°C for GTT. They were removed from the incubator and evaluated after 30 min, 1 h, 2 h, and 3 h of incubation. The GTT was accepted to be positive only if germ tube was 1/2 the width and 3 times the length of the parent yeast cell and with no constriction at the point of origin. Results: When the use of serums and MHA for GTT was statistically evaluated, according to the positive scoring, the best results were obtained with MHA and with rabbit, horse, and fetal bovine serum, respectively. The best definition over time statistically was the third hour. Conclusion: It is suggested that inexpensive MHA is a fast, appropriate, and reliable medium for the probable diagnosis of GTT and C. albicans; however, additional studies are still needed to define other Candida species.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Context: Torus mandibularis (TM) and torus palatinus (TP) are believed to occur commonly among black Africans. There is a dearth of literature on Nigerians. The few reported studies were done in the South-West Nigeria. This is the first report of the prevalence of tori among the Ibo-speaking ethnic group in the South-East Nigeria. Settings and Design: This is a prospective cross-sectional study of 3000 subjects of Ibo ethnic extraction attending a dental clinic in Enugu, South-East Nigeria. Materials and Methods: Three thousand subjects were examined for the isolated and concurrent occurrence of TM and TP. The subjects were seen over a 4-year period. The age, sex, ethnic group, type of tori based on location, and symptomatic awareness of tori presence were documented. Statistical Analysis Used: The data were analyzed with Statistical Package for Social Sciences (SPSS) version 17. The level of significance was P< 0.05. The Chi-square test showed no statistically significant difference between gender and type of tori (P = 0.34). Similarly, there was no statistically significant difference between the age groups and type of tori (P = 0.38). Results: Two hundred and ninety-two subjects were clinically diagnosed with tori, of which females constituted 88%, and males constituted 12%. Isolated TM occurred in 56.8% (166 of 292) subjects, isolated TP in 17.5% (51 of 292) subjects, and concurrent tori (TM and TP) in 25.7% (75 of 292) subjects. The peak occurrence was in the fifth decade. The overall prevalence was 9.7%. The prevalences of TM (isolated and concurrent) and TP (isolated and concurrent) were 8.0% and 4.2%, respectively. Conclusions: The prevalence values are within the range of values reported in other Nigerian studies but differ widely with values from other ethnic groups from other countries.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]  [PubMed]

Background: Obesity is one of the leading preventable causes of death worldwide. Objective: To compare body compositions in obese and nonobese individuals. Methods: This cross-sectional study constituted of 428 individuals. Body compositions were determined using the Tanita. Results: Of all the participants, 300 (70.1%) were female. The prevalence of overweight and obesity was 30.8% and 47.7%, respectively. Having low educational level, female gender, not working, being married, and nonsmoker significantly increased more in obese than nonobese (P < 0.001). Total body water, visceral fat accumulation, body mass index, resting metabolic rate, fat-free mass, bone mass, and muscle mass were significantly higher in obese when compared to those with nonobese (P < 0.001). Thirteen percent of the participants were thinking of changing their diet and lifestyle to lose weight at the beginning. After learning their body compositions, the rate increased to 60% who decided to modify their lifestyle and asked for help to lose weight. This behavior change was significant in especially the overweighted participants (P = 0.025). Conclusion: The changes in body composition are associated with obesity and increased risk for certain cancers, cardiovascular disease, type 2 diabetes mellitus. Learning the health risks can motivate losing weight. Multicentered studies can be illuminating different cultural factors about obesity.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]