Aim: The aim of this study is to examine the role of the mean platelet volume (MPV), platelet distribution width (PDW), platelet/lymphocyte ratio (PLR), and platelet values for predicting mortality in patients with sepsis. Materials and Methods: This is a retrospective study, involving patients 18 years and above who were diagnosed with sepsis. Blood samples were analyzed for platelets characteristics (counts, MPV, PDW, and PLR). The patients were separated into two groups namely the survivors and deceased. The two groups' MPV, PDW, PLR, and platelet counts which were considered to have an effect on mortality, were compared. Results: Three hundred and thirty patients who were diagnosed with sepsis in our emergency department and complying with the study participation criteria were studied retrospectively. Comparison of the MPV, PDW, PLR, and platelet counts of the deceased and survivors showed that the MPV, PDW, and PLR were higher in the deceased while the platelet counts were higher in the survivors. Conclusion: The low number of platelets in patients with sepsis at the moment of application and the high PDW and PLR values are valuable for predicting a high mortality.

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Context: Restless legs syndrome (RLS) is a sensorimotor disorder that often has a profound impact on sleep and one of the most troublesome conditions experienced in hemodialysis patients. Aims: The aim of study was to search frequency of RLS and effects of RLS on quality of life (QoL) in chronic hemodialysis patients. Settings and Design: Chronic hemodialysis patients of classical hemodialysis units were chosen. Length of the study was approximately 1 year. Subjects and Methods: Two hundred and thirty-seven patients were investigated. RLS was diagnosed using to international the RLS questionnaire. The International RLS (IRLS) rating scale was used to calculate RLS severity. QoL was assessed using the World Health Organization QoL brief version (WHOQOL-BREF) instrument. Statistical Analysis Used: Student's t-test, Chi-square test or Fisher's exact test, Bonferroni correction for multiple comparisons, and Pearson or Spearman correlation analysis were used. Significance level was P < 0.05. Results: The overall prevalence of RLS according to the four essential criteria was 18.6% (n = 44). According to IRLS, 22.7% of the patients with RLS were mild (n = 10), 63.6% were moderate (n = 28), and 13.7% were severe (n = 6). The parameters of QoL were compared in RLS-positive and negative patients. There was no significant difference in psychological health (P = 0.971), social relationships (P = 0.462), and environment (P = 0.483) between two groups. Only the physical health scores were higher in without RLS than patients with RLS (P = 0.027). Conclusions: This study revealed that the frequency of RLS among chronic hemodialysis patients is 18.6% and RLS leads to physical life quality disturbances.

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Bochdalek hernia is a congenital abnormality with high morbidity and mortality characterized by passage of the abdominal organs into the thoracic cavity through a diaphragmatic defect. Intrathoracic location of abdominal organs such as kidneys is very rare, with a reported incidence of only 0.25% in the literature. Herein, we present two cases of Bochdalek hernia with a herniation of intra-abdominal organ such as kidney that was treated in our clinic and compare this rare case with those in the literature. In both cases, the functionally normal kidneys were left in situ during diaphragmatic repair. No complications were observed during the postoperative period, and 10- and 1-year follow-ups. In cases with Bochdalek hernia associated with an intrathoracic ectopic kidney, the functionally normal ectopic kidneys were left in situ during repair of the diaphragmatic defect without complications.

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Background: Allergic diseases are known to occur in children with asthma and its coexistence with asthma may impact on asthma control in affected children living in a low-income country. The study is to determine the allergic profile of children with asthma and the association with asthma control and attendant social risk factors. Materials and Methods: This was a cross-sectional study of consecutively enrolled children with physician diagnosed asthma, attending clinics in a tertiary center in Nigeria. The presence of asthma, allergy types, and asthma control levels were determined using the Gobal initiative on asthma (GINA), international study of asthma and allergy in childhood and asthma control test questionnaires, respectively. Results: There were 207 children with asthma enrolled from the Pediatric Asthma Clinic at University of Nigeria Teaching Hospital, Enugu. The median age was 10 years and interquartile range of 7–11 years. There were 127 (61.4%) from middle and high socioeconomic class and 86.5% who lived in the urban areas. Of the study participants, 41.5% had one or more allergy symptoms; rhinitis (33.3%), conjunctivitis (29.0%), and dermatitis (7.2%). Allergy symptoms persisted from infancy in 55.9%. Children from large families had a lower prevalence of allergies. Having any allergy symptom and belonging to a small-sized family were both associated with asthma exacerbations. Most children studied, (69.1%) had their asthma under control. Allergy persistence from infancy and type of allergy were not significantly associated with the level of asthma control. Conclusion: Allergic diseases are common in children with asthma in our environment, but did not significantly impact on asthma control. Socioeconomic factors such as urbanization and family size had effects on the achievement of asthma control but not on allergy status.

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Background: Liver size can be influenced by various factors, including malignant diseases, infective processes, and anthropometric variations among individuals from different geographical locations and races. Therefore, the exact definition of hepatomegaly in the ultrasonographic measurement of liver size is controversial. Moreover, the majority of studies regarding the study of liver size are not community-based. Aims: The aim of this study is to establish a range of normal liver sizes by ultrasonography with respect to age and sex in healthy individuals and to identify factors affecting liver size. Study Design: This was a prospective, community-based study. Methods: Liver size was measured ultrasonographically from the midclavicular line in 822 individuals, of which 49.3% (n = 405) were male and 51.7% (n = 417) were female. Following physical examination, all participants provided blood samples. Height, weight, and waist circumference were recorded. The mean liver length was calculated for males, females, and for the whole study group. It was also determined whether there was an association between liver size and age, weight, height, body mass index (BMI), body surface area, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) enzyme levels. Results: The mean liver length was significantly different between males (150.04 ± 14.84) and females (147.57 ± 18.32, P = 0.034). Weight and BMI were the most strongly associated with liver size. There was a significant difference between liver size in individuals with normal and elevated levels of AST and ALT enzymes (P < 0.01). Conclusion: In a northern Anatolian Turkish population, liver size was greater among males than females. In light of these data, we believe our study may serve as a reference source for the evaluation of liver size.

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Aims: Orthodontic mini-implants are important devices for successful anchorage management in orthodontics; however, the survival of these devices depends on several clinical factors. The aim of our study was to calculate the success and complication rates of orthodontic mini-implants. Materials and Methods: In this retrospective study, patients of our orthodontic department were enrolled, getting overall 59 orthodontic mini-implants during their orthodontic treatment in a 2-year period. Every patient had one or more of the 1.6 mm × 8 mm in size self-drilling mini-implants (Jeil Dual Top Anchor System, Jeil Medical Corp., Seoul, Korea). Screw loading was performed immediately after insertions, keeping tension forces under 150 g. Soft tissue and bone infections, implant mobility and screw loss, implant fracture, and neighboring tooth injury were registered. Relationships between variables were tested using the Chi-square test for statistical significance. Results: The success rate of the orthodontic mini-implants was 89.8% in this study while the average loading period was 8.1 months. Soft-tissue infections varied between 6.3% and 33.3% of the cases while screw mobility varied between 3.1% and 20.8% of the cases regarding the anatomic localization. Screw mobility was significantly more frequent in the buccal fold than in the palate (P = 0.034). Screw mobility was significantly more frequent in the buccal fold than in the palate (P = 0.034) and screw mobility was found more frequently in case of intrusions than by extrusions (P = 0.036). Conclusions: The overall success rate of mini-implants was found acceptable in this study, however, screw mobility in the buccal fold showed a high incidence, suggesting the thorough consideration of the immediate loading by buccal mini-implants.

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Background: Infection control practices are crucial and important elements in clinical dentistry as there is an increase in the prevalence of infectious diseases among dental patients. This necessitates the application of recommended procedures for infection control in dental schools and clinics. Objectives: The aim is to evaluate the awareness, knowledge, and attitude of the undergraduate dental students toward infection control measures in the prosthodontic clinic and to assess their satisfaction toward applying these measures during prosthodontic treatment. Materials and Methods: A questionnaire-based study was conducted among 180 third, fourth and fifth year dental students (119 females and 61 males) in November 2015 in a private dental school of Rani Durgawati University, Jabalpur (Madhya Pradesh), India. It included 25 close-ended questions related to vaccination status and previous sharp injuries, awareness, knowledge, and attitude toward infection control in the prosthodontic clinic, previous education about infection control, and subjects' satisfaction with their knowledge and attitude. The questionnaire was distributed among 3^rd, 4^th, and 5^th year students and informed consent were obtained before commencing the questionnaire. Results: A total of 180 participants responded to the questionnaire. Their perception toward infection control practices in the prosthodontic clinic varied from 14.4% to 100%, where former were regularly disinfecting dental cast before sending it to the laboratory and later ones were regularly using gloves while attending the patient. Most of the subjects responded “good” or “fair” to the questions related to the evaluation of their knowledge and policy implementation of infection control in prosthodontic clinic (P < 0.0001). Around 47.8% were almost satisfied, and 28.9% were fairly satisfied with their knowledge and performance. Conclusions: The study findings showed inadequate attitude and awareness of subjects toward infection control in prosthodontic practice. Their self-assessment and satisfaction reflect their performance toward infection control policy.

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Background: Mortality in patients with severe acute cholecystitis (AC) remains high, and the prognosis for elderly patients tends to be poor. A comparative analysis of clinical, laboratory, and abdominal computed tomography (CT) parameters was conducted in this study to investigate the effectiveness of each index for predicting clinically severe AC in elderly patients in the emergency department (ED). Methods: This was a single-center, retrospective study that included 156 patients (≥65 years of age) with AC who were admitted in the ED between January 2012 and December 2014. Parameters including age, gender, initial clinical findings, laboratory findings, and CT findings in the ED were examined for their ability to predict severity. Results: Forty-five patients were diagnosed with clinically severe AC. The white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein, erythrocyte sedimentation rate, protein, albumin, and prothrombin time/International Normalized Ratio values were significantly higher in the severe group than in the nonsevere group (P < 0.05). In addition, the CT parameters of increased pericholecystic fat stranding and pericholecystic fluid collection were significantly higher in the severe group than in the nonsevere group (P < 0.001, P < 0.001). Increased pericholecystic fat stranding (odds ratio [OR], 8.17; 95% confidence interval [CI], 2.29–29.22; P = 0.001), pericholecystic fluid collection (OR, 6.55; 95% CI, 1.39–30.92; P = 0.018), and an NLR cutoff value of 9.9 (OR, 4.20; 95% CI, 1.01–17.53; P = 0.049) were independent predictors of severe AC in elderly patients. Conclusions: The CT parameters of increased pericholecystic fat stranding and pericholecystic fluid collection with an NLR cutoff of 9.9 were useful for predicting the severity of AC in elderly patients in the ED.

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Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare chronic and recurrent disease with unknown etiology. It characterized by shallow ulcers, submucosa thickness, and no signs of systematic inflammation. Now, steroids are the principle therapy for CMSUE. However, still, there were few patients who did not response to it. Here, we present a young woman who diagnosed with CMUSE. She underwent a surgery because of capsule endoscopy retention. After relapse, she had received budesonide and methylprednisolone separately while both of them did not stop her disease. Till now, 24 years after her initial symptom, there are no signs of carcinoma yet.

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Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for inflammation control and pain relief. However, while the adjunct use of NSAIDs is avoided for periodontal therapy because of related side effects, cyclic administration of NSAIDs may reduce or eliminate these effects. We evaluated the effect of a cyclic diclofenac potassium (DP) regimen on clinical parameters and levels of prostaglandin E₂ (PGE₂) and interleukin-1β (IL-1β) in the gingival crevicular fluid (GCF) of individuals with periodontitis. Materials and Methods: The study protocol was approved by the Ethics Committee (2000/071). Forty-one individuals with chronic periodontitis (33 men, 8 women) were divided into two groups (test and control) after initial periodontal therapy. During this 6-month, randomized, double-blind, placebo-controlled study, test (n = 28) and control (n = 13) groups were administered a cyclic regimen of DP (50 mg, twice daily) or placebo. Clinical measurements and GCF sample collections were made at baseline, 2, 4, and 6 months. GCF levels of PGE₂and IL-1β were determined using enzyme immunoassay and enzyme-linked immunoassay kits, respectively. Results: At baseline, no significant differences existed between groups for plaque indices, gingival indices, bleeding on probing, probing depth (PD), or attachment levels (P > 0.05). Compared with the control group, cyclic regimen in the test group suppressed increased levels of PGE₂found in GCF at the end of the study (P < 0.05). Significant differences for PD and relative attachment gain were also noted in favor of the test group (P < 0.05). Conclusions: These results suggest that a cyclic regimen of DP may be efficacious in the management of chronic periodontitis in adults.

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Aim: In this study, we investigated the retention of two attachment types, Straumann ball (SB) and Straumann Locator^® (SL) attachments, on different implant angulations and identified the most appropriate treatment type or attachment system for each angulation. Materials and Methods: The attachments placed on angulation of 0°-, 10°-, and 20° implants were subjected to 1440 vertical insertion-separation cycles. The retention values of the attachments after 0, 720, and 1440 cycles were measured using the Instron machine. In addition, scanning electron microscopy images of the attachments and abutments were obtained before and after the insertion–separation process. Results: There was a significant difference between the SB and SL attachments that were placed on 0° after 1440 cycles (P < 0.05) and between 20° SB and 20° SL attachments after 720 and 1440 cycles (P < 0.05) in terms of retention. No significant difference was observed between 20° SB and 20° SL attachments at 0 cycles (P > 0.05). Conclusions: In implants with a 20° angle, retention of stud attachments decreased more than ball attachments after use. Thus, the total angle between the implants should not be <20° if long-term retention is desired when using stud attachments. For implants with angles >20°, 6-month patient controls are required to control retention of attachments by considering factors in the mouth with the two tested attachment systems.

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Objective: The aim of this study was to evaluate in vitro shear bond strength (SBS) and in vivo bond survival rates of brackets bonded using orthodontic indirect bonding resins. Materials and Methods: For the in vitro study, the first group was direct bonding control group. In Groups II and III, bonding was performed with indirect bonding resins that were either chemically or light-cured. The SBS of each sample was examined. For the in vivo study, full-mouth brackets were placed in 20 patients using a split-mouth approach, with either chemically-cured or a light-cured indirect bonding resin. The patients were followed for 12 months. Data were statistically evaluated using analysis of variance, Tukey's tests, and Weibull survival analysis. Results: The mean SBS values (MPa) were 17.6 ± 6.6, 13.1 ± 4.7, and 15.1 ± 5.9 for Group I, Groups II, and III, respectively, (P < 0.05). The adhesive remnant index scores of the groups were generally Score 3 and Score 4. In vivo follow-up showed no statistically significant differences in total bond failure rate between groups (P > 0.05). Conclusions: In vitro study showed lower SBS with chemically-cured indirect bonding resin than flowable light-cured resin and the control group, but in vivo failure rates of both indirect resins were found to be adequate for clinical usage.

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Aim: The aim of this study is to evaluate the spiritual care interventions of the nurses in hospitals. Subjects and Methods: Nurses employed in the 5 hospitals of Eastern Black Sea Region constitute the universe of the research that was planned to be descriptive. 1254 out of 1765 nurses were reached out between 1-30 May 2015 without a sample selection. The data were collected by the researchers is based on face-to-face survey techniques in which sociodemographic attributes built on literature and opinions on spiritual care were evaluated. Permission of the hospitals and nurses were obtained for the study. Number and percentage distributions and Chi-square test were used for statistical analysis. Results: As the nurses' sociodemographic attributes were examined, 29.3% of them belonged to 30–35 age group, 26% of them worked as a nurse manager for 82–161 months, and 56.7% of them worked for 162–300 months. Ninety-one percent of them stated that they never practiced spiritual care-related nursing, 97.5% of them stated that they never received support from hospital clergymen, 93.2% of them stated that they did not talk about spiritual need with the patient since they did not find it necessary. Conclusions: This study showed that there is very little or no interventions directed at the spiritual dimension during the patient's caring process.

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Introduction: The prevalence of major congenital anomalies (CAs) shows wide variations depending on geographical location and may range from <1% to 8% and it causes between 20% and 30% of perinatal deaths. In Nigeria, the prevalence of CAs may be underestimated with the general reliance on mostly livebirths ranging between 0.5% and 2.8% exempting cases of miscarriage and abortions. The purpose of this study was to determine the epidemiologic pattern and outcome of major CAs detected prenatally at the University College Hospital, Ibadan, Nigeria, over a 4-year period. Methods: This hospital-based descriptive study highlights the prevalence and pattern of prenatally diagnosed fetal anomalies among the pregnant women who presented for routine prenatal ultrasound screening within the study period. Demographic details, associated risk factors, and fetal anomaly type in the fetuses were recorded using a prepared pro forma and were analyzed. Results: Prenatal ultrasound screening for fetal anomalies was performed on 989 fetuses (including 15 sets of twins and 1 set of triplets) during the study period, out of which 62 (6.3%) had CAs. Of the 62 with CAs, 37 (59.7%) were major and 25 (40.3%) were minor. Majority of the fetuses with major anomalies were found among women aged 30–34 years and most were detected during the routine 18–22 weeks' anomaly scan. The major anomalies were most common in central nervous system. Nine (14.5%) pregnancies were terminated before term and 8 (29.6%) babies had different postnatal surgical interventions. Eleven (17.7%) of the fetuses with anomalies died in the perinatal period. Conclusion: CAs remain a major contributor to perinatal morbidity and mortality in Nigeria. Since most are idiopathic, early prenatal detection with ultrasound may facilitate improved diagnosis and the reduction of overall perinatal morbidity and mortality in the Nigerian setting.

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Purpose: After mental nerve injury, several sensory disorders may occur. The alterations in sensation may differ from mild paresthesia to complete anesthesia, or neuropathic pain. Neuropathic pain is a difficult clinical condition to manage. The aim of this study was to compare the analgesic effects of pulsed radiofrequency (PRF) and cryoablation in an experimental mental nerve neuropathic pain model in rabbits. Materials and Methods: Fifteen rabbits were divided into three groups. One-third to one-half of the mental nerve was ligated with 4-0 silk sutures. In Group 1, a nonconducting PRF electrode was placed on the mental nerve for 6 min, whereas the mental nerve was exposed to PRF in Group 2. In Group 3, the cryoablation was processed. The responses to thermal and mechanical stimuli were measured at the 1^st, 2^nd, 3^rd, and 4^th weeks. Results: There were no statistically significant differences among the groups for thermal withdrawal latency to heat stimulation in any weeks (P > 0.05). However, a significant difference was found between the groups (P < 0.05) in the 3^rd and 4^th weeks for mechanical withdrawal latency values. Conclusions: Both PRF and cryoablation therapies are successful in the treatment of experimentally induced mental nerve neuropathic pain in rabbits.

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Objective: The purpose of this in vitro investigation was to assess the effect of deproteinization before and after acid etching on the surface roughness of immature human enamel of permanent teeth compared to acid etching alone using noncontact three-dimensional (3D) optical profilometer. Materials and Methods: Forty-eight enamel blocks were randomly distributed into 4 groups (12 each) according to the surface treatment in the form of deproteinized with 2.5% sodium hypochlorite (NaOCl) before and after acid etching with 32% phosphoric acid (H3PO4) compared to application of H3PO4 alone. The surface roughness (Sa) was measured using a 3D optical noncontact surface profiler. Two specimens from each group were selected and prepared for scanning electron microscopic (SEM) analysis. Shapiro–Wilk test, one-way analysis of variance, and Tukey's honest significance difference test were used. All statistical analyses were established with a significance level of P < 0.05. Results: The highest surface roughness (Sa) was recorded for Group 3/NaOCl ± H3PO4 and the lowest Sa was recorded for Group 1 (control). All surface treatments applied showed significantly greater values of surface roughness (Sa) than the enamel surfaces with no surface treatment (control). There was significant difference between control group and Group 2/H3PO4 (P = 0.002), Group 3/NaOCl ± H3PO4 (P = 0.0001), and Group 4/H3PO4 ± NaOCl (P = 0.017). There was no significant difference between Group 2/H3PO4 and Group 4/H3PO4 ± NaOCl. SEM evaluation showed different topographical features of deproteinized enamel surface. Conclusions: Deproteinizing the enamel of immature permanent teeth with 2.5% NaOCl before and after acid etching with 32% H3PO4 increased surface roughness compared to the application of H3PO4 alone.

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Aim: This study aimed to determine the risk factors for postoperative nausea and vomiting (PONV) in children receiving dental treatment under general anesthesia and to identify the subcategories leading to risk formation. Materials and Methods: The study comprised of 100 American Society of Anesthesiologists I patients aged 2–7 years who were administered dental treatment under general anesthesia. Patients were evaluated with regard to PONV risk. Eight different independent risk factors were identified as follows: age, gender, weight, duration of anesthesia, duration of recovery, postoperative pain, rescue analgesia, and type of dental treatment. Classification and regression trees method was used to choose the best predictor for PONV. Results: The incidence of PONV was 25%. No significant difference was found between those with PONV and those without PONV with regard to gender, weight, duration of anesthesia, duration of recovery, or the type of dental treatment (P > 0.05). However, postoperative pain level and use of rescue analgesia with tenoxicam were both predictors of PONV (P < 0.05). For the postoperative pain (≤1.5) subgroup, age proved to be the best predictive variable. Conclusion: The risk limit for PONV was determined to be ≥5.5 years for children who underwent dental procedures under general anesthesia. Postoperative pain and rescue analgesia constituted risks for PONV.

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Spontaneous heterotopic pregnancy is an uncommon clinical condition in which there is a simultaneous development of intrauterine and extrauterine pregnancies. It is a life-threatening emergency when the ectopic ruptures. We present Mrs. EC, a 27-year-old G₁P⁰ + ⁰ with a family history of multiple gestations who had a heterotopic pregnancy at a gestational age of 7 weeks. She presented with features of threatened miscarriage at early pregnancy with an ultrasound confirmation of intrauterine pregnancy. The diagnosis of ruptured ectopic pregnancy coexisting with intrauterine gestation was made with ultrasound findings as well as clinical features necessitating emergency exploratory laparotomy. Thereafter, pregnancy was carried to term, and she delivered a live male baby that weighed 3.0 kg. Heterotopic pregnancy should be sort for in all pregnancies during the early scan, especially in those with predisposing factors for multiple gestations and risk factors for ectopic gestation. A high index of suspicion is necessary for making a diagnosis in women with intrauterine pregnancy, with or without symptoms of ectopic gestation, and irrespective of the existence of risk factors for ectopic pregnancy.

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Introduction: The pattern of cancer is known to vary by location based on people's lifestyle and socioeconomic development status. Aim: The aim of this study is to describe the pattern of cancers seen in University of Uyo Teaching Hospital. Materials and Methods: This is a retrospective study of all cancer cases that were histologically diagnosed in the Histopathology Department of University of Uyo Teaching Hospital for 9 years (January 2007–December 2015). Results: There were 1186 cases, identified and included in this study. Females accounted for 59.7% of cases while males accounted for 40.3% of cases, with the mean ages for females and males being 45.69 ± 14.38 and 59.63 ± 17.77 years, respectively. Age group 60–69 years accounted for most cases (20.4%). The common cancers in both sexes were breast (33%), prostate (25.8%), cervix (11.1%), skin (4.9%), sarcoma (4.8%), and colorectal (3.8%). Conclusion: There is a variation between the pattern of cancer in Akwa Ibom and other regions of Nigeria warranting further clinicopathological evaluation, and these results will be useful in the overall context of planning and evaluation of cancer control activities in Akwa Ibom State. A population-based cancer registration in Uyo is suggested.

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Objective: The aim was to compare mandibular arch and incisor inclinational changes by comparing active self-ligating brackets used with different forms of archwires with a control group in nonextraction cases. Materials and Methods: The sample of 50 patients with Class I malocclusion was divided into three groups: Group I was treated with active self-ligating brackets (Nexus, Ormco/Orange, CA, USA) used with Damon arch form copper nickel-titanium (Cu-NiTi) and stainless steel (SS) wires; Group II was treated with interactive self-ligating bracket system (Empower, American Orthodontics, Sheboygan, Wis, USA) used with standard Cu-NiTi and SS wires; and Group III was treated with Roth prescribed conventional brackets (Forestadent, Pforzheim, Germany) with standard Cu-NiTi and SS wires which was designed as a control group. Changes in dimension of mandibular arch and inclination of incisors were assessed on dental models and lateral cephalometric radiographs at pretreatment (T1) and posttreatment (T2) periods. Paired-t test and one-way analysis of variance were used to perform intragroup and intergroup comparisons, respectively. Results: In all groups, an average increase of transversal distances occurred from pretreatment to the posttreatment period (P < 0.05). However, mandibular arch length increase was significantly different among the Groups I-III (P = 0.008) and I-II (P = 0.006). No significant intergroup difference was found with regard to incisor inclinational changes. Conclusions: Bracket type had no significant effect on the mandibular dimensional or incisor inclination changes. Besides this, archwire type had only little effect on the treatment results as active self-ligating bracket with Damon archwires increased mandibular arch length greater than other groups.

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Background: Hypertension can secondarily involve the kidneys, and renal sonographic parameters can be used to indirectly assess renal function or status. Ultrasound is an inexpensive and safe modality for evaluating the kidneys. The purpose of this study was to sonographically assess renal parameters in patients with essential hypertension to determine the parameters that may indicate increased risk of renal damage. Materials and Methods: One hundred and fifty individuals (96 females and 54 males) with essential hypertension attending consultant outpatient clinic in University of Benin Teaching Hospital were evaluated. An equal number of nonhypertensive volunteers comprising of 80 females and 70 males were studied as controls. For individuals and controls, the renal length, width, anteroposterior diameters, renal parenchymal volume, cortical thickness, and echogenicity were assessed. Serum creatinine was also obtained. Statistical Package for the Social Sciences (SPSS version 17.0) was used in data analysis. Results: The mean renal parenchymal volume and cortical thickness were 99.1 ± 25.8 cm³ and 1.0 ± 0.2 cm on the right and 113.8 ± 35.8 cm³ and 1.0 ± 0.2 cm on the left for the hypertensive individuals. The values for the normotensives were 100.5 ± 19.8 cm³ and 1.2 ± 0.2 cm on the right and 118.7 ± 27.4 cm³ and 1.3 ± 0.2 cm on the left. The difference in cortical thickness between the two groups was statistically significant. No significant difference was noted between renal parenchymal volume of the right and left kidneys in the individuals and controls. The variation in cortical echogenicity between the hypertensives and controls was statistically significant; 74.0% and 75.3% of hypertensives and 28.0% and 26.0% of normotensives had increased cortical echogenicity on the right and left kidneys, respectively. The serum creatinine value was significantly higher in the hypertensive group. Conclusion: Cortical echogenicity grading was significantly higher among hypertensives than normotensives while renal parenchymal volume and cortical thickness were lower among hypertensives. In the hypertensives and normotensives, renal parenchymal volume, cortical thickness, and renal length were higher in males compared to the females and in the left kidney compared to the right. Hypertension seems to have more effect in the renal cortex than the medulla.

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Objective: Patients hospitalized in Intensive Care Units (ICU) are critically ill. Sometimes informed consent for invasive procedures cannot be obtained from patients or relatives due to insufficient information. Methodology: Relatives of the patients who were being hospitalized in ICUs of state hospitals in 3 provinces in Eastern part of Turkey during year 2015, who were planned to undergo central venous catheter insertion, tracheostomy, and percutaneous gastroenterostomy (PGE) were asked to sign consent forms and these relatives were included in the study. The study groups were allocated as verbal (VeIG) and verbal-visual information groups (ViIG). The next of kin who had the right for signing was included in the study. Results: Relatives of patients were interviewed for 512 invasive procedures. For the central venous catheterization, 91.6% of the VeIG (n = 166) and 97.6% of the ViIG (n = 166) accepted the central venous catheterization interventions (n = 332), for the tracheostomy, 65.3% of the VeIG (n = 49), 85.4% of the ViIG (n = 48) accepted the tracheostomy interventions (n = 97), and for the PGE, 23.8% of the VeIG (n = 42) and 48.8% of the ViIG (n = 41) accepted the PGE interventions (n = 83). A statistically significant difference was detected between VeIG and ViIG with regard to approval and refusal rates for different interventions. When approval-refusal rates were compared with regard to education level, statistically significant difference was not detected between VeIG and ViIG with regard to approval and refusal rates. Conclusions: Using visual materials such as video in addition to verbal information provided an improvement in consent ratios regardless of education levels.

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Introduction: The entire genetic information carried by an organism makes up its genome. Genes have a diverse number of functions. They code different proteins for normal proliferation of cells. However, changes in the base sequence of genes affect their protein by-products which act as messengers for normal cellular functions such as proliferation and repairs. Salient processes for maintaining the integrity of the genome are hinged on intricate mechanisms put in place for the evolution to tackle genomic stresses. Aim: To discuss how cells sense and repair damage to their deoxyribonucleic acid (DNA) as well as to highlight how defects in the genes involved in DNA repair contribute to cancer development. Methodology: Online searches on the following databases such as Google Scholar, PubMed, Biomed Central, and SciELO were done. Attempt was made to review articles with keywords such as cancer, cell cycle, tumor suppressor genes, and DNA repair. Results: The cell cycle, tumor suppression genes, DNA repair mechanism, as well as their contribution to cancer development, were discussed and reviewed. Conclusion: Knowledge on how cells detect and repair DNA damage through an array of mechanisms should allay our anxiety as regards cancer development. More studies on DNA damage detection and repair processes are important toward a holistic approach to cancer treatment.

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