Aim: The aim of the present study was to investigate the value of serum procalcitonin (PCT) measurements for the prediction of sepsis in pediatric patients with burn injuries. Method: All pediatric patients with burn aged between 1 and 15 years who were treated at Burn Centre of Kartal Training and Research Hospital, Istanbul, Turkey between January 2014 and January 2015 were included in this study. The patients were classified into three groups according to levels of serum PCT. Groups one, two, and three consisted of patients with PCT levels lower than 0.5 ng/dl, patients with PCT levels 0.5--2.0 ng/dl, and patients with PCT levels greater than 2.0 ng/dl, respectively. Demographic data (age, gender), burn etiology, body region of burns, percentage of affected total body surface area (TBSA), antibiotic requirement, intensive care unit (ICU) requirement, hospitalization time, blood culture results, and mortality were evaluated in relation to PCT levels. Results: The mean PCT level at admittance was 2.2 ± 5.8 ng/dl. There were 52, 7, and 11 patients in group one, two, and three, respectively. Higher PCT levels were significantly associated with higher percentage TBSA (P < 0.001), positive blood cultures (P < 0.001), higher requirement of antibiotics and intensive care (P = 0.004 and P < 0.001, respectively), and longer hospitalization time (P < 0,001). Conclusion: High PCT levels may be a predictive biomarker for the development of sepsis in pediatric patients with burn injury. However, more comprehensive prospective studies may be required to validate this finding.

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Background: The use of smartphones is now ubiquitous in developed countries and many studies have documented their use as a point of care tool, for communication and for reference purposes among various categories of doctors. In Africa and in Nigeria, fewer studies have been conducted and these have been confined to medical students, Interns and resident doctors. Aims and Methods: The aims of our study were to examine ownership, frequency and pattern of use and problems encountered in the use of smartphones among all category of doctors in hospitals in Kaduna, Nigeria. Results: A 20-item structured questionnaire was completed by 326 doctors from public and private/faith-based hospitals (aged 23 – 70 years, median 34, two thirds male). All but one respondent owned a smartphone and 99% reported using these during their work in hospital. The following activities were the most frequently performed (at least once a day) using smartphones: Check details about a disease (48.7% of respondents), Medscape (45.9%), voice/text to colleague (45.3%), check differential diagnosis (39.1%), Social Media (37.9%), check drug interactions (34.9%), find indications for use of drugs (34.3%), and use of drugs in special circumstances (33.8%). Younger doctors (less than 40 years) and particularly Interns/NYSC doctors and doctors within 10 years of graduation, were significantly more likely to perform above-mentioned activities. 86% of respondents graded their phones as very useful or invaluable. Perceived lack of time and unreliable internet were the most commonly reported barriers to optimal use. Conclusion: Smartphone use in hospitals among doctors in Kaduna is universal and is mainly for point of care, communication and reference purposes.

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Objectives: Hypercementosis (HC) is an asymptomatic excessive cementum deposition at the dental root apex. There is a lack of research that determines the pattern and associated factors of HC in Saudi Arabia. Materıals and Methods: A retrospective cross-sectional study was conducted on a random sample of 815 Orthopantomograms (OPGs) that was obtained from a total of 14003 female patients archived OPGs. The OPGs were retrieved from the Kodak Carestream-R4 database for the period between 2015 and 2017 at Taibah University Dental College and Hospital (TUDCH), Al-Madinah Al-Munawwarah, Saudi Arabia. Width and radiodensity of HC were measured and the distribution was calculated. Association between HC and factors including age and nationality were explored. Descriptive and inferential analyses were performed. Results: The mean/SD age of HC affected patients (9.8%) was 30.16 ± 13.1 years, of whom 55% were Saudis. The mean/SD width and radiodensity of the hypercementosed roots were 4.14 ± 1.2 mm and 119.86 ± 29.83, respectively. The mandibular teeth were more frequently associated with hypercementosis (65%) specifically first molars (47.5%), while the majority (64%) had a single unilateral distribution pattern. There was a non-significant association between nationality, age, and HC (P = 0.921, P = 0.633, respectively). Conclusion: Hypercementosis observed in 9.8% of female patients attending TUDCH which was primarily unilateral and prominently confined to the mandibular teeth roots. The complication of teeth extraction among female patients in Almadinah region should be anticipated.

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Background: The aim of this study was to evaluate six different glass ionomer cement (GIC)-based restorative materials through comparisons of microleakage and fluoride release. Materials and Methods: For microleakage, 30 teeth were randomly separated into 6 groups of 5: Group 1 (Dyract: compomer), Group 2 (Freedom: compomer), Group 3 (Equia: high-viscosity glass ionomer cements), Group 4 (Fuji IX: resin-modified glass ionomer cement), Group 5 (Ketac Molar: traditional glass ionomer cement [TGIC]) and Group 6 (Voco: TGIC). For fluoride release of six different GIC-based restorative materials, standard samples were prepared of 4 mm thickness and 7 mm diameter. A total of 60 samples were obtained as 10 samples from each group. The analyses were made using a Thermo Orion 720 A+ ionometer with the Orion fluoride electrode. At the end of 24 h, 72 h, 7 days, 14 days, and 30 days, the electrode was placed into the dish containing the sample, distilled water, and TISAB II; a reading was taken; and the value shown on the screen was recorded. Results: For microleakage, a statistically significant difference was determined between the groups in respect of the occlusal variable (P < 0.05), no statistically significant gingival variable (P > 0.05). About fluoride release: According to the repeated measures variance analysis results, the difference between the groups, and between the time-group interaction and according to time, was found to be statistically significant (P < 0.05). Conclusions: In terms of microleakage, it was concluded that all materials could be used in clinical applications. The Equia high-viscosity glass ionomer cements (HVGIC) was determined to be the material with the highest fluoride release value.

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Aim: The high incidence of caries in first permanent molars (FPMs) makes premature extraction of these teeth common. The extraction of the permanent teeth results in various changes in the dental arch. The aim of this study was to evaluate space closure, the eruption of second permanent molars (SPMs), and changes in dental arch after extraction of the FPMs. Materials and Methods: Eruption of 83 SPMs was recorded and radiographically developmental stage of these SPMs in the pre-extraction panoramic radiograph was assessed. Space was measured between the distal surface of the second premolar and the mesial surface of SPM. Results: Out of 55 patients, 28 (50.9%) were males and 27 (49.1%) were females. Thirty-seven (44.6%) of 83 teeth belonged to category 1, 17 (20.5%) teeth belonged to category 2, and 5 (6.02%) teeth belonged to category 3. Although category 4 was not found, 24 (28.9%) teeth were observed to be in category 5. Out of all SPMs, 10.8% represented the ''ideal'' stage of Demirjian's dental development, stage E. Conclusion: In patients who had the FPMs extracted before the eruption of the SPM, it is important with regards to the patients' comfort and health to review the patient regularly and to determine any need for orthodontic treatment.

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Bardet–Biedl syndrome (BBS) is a rare autosomal recessive genetic disorder. This syndrome is associated with 19 genes present, and 80% of the cases are determined as a clinical diagnosis result. A 15-year-old female presented with a complaint of gingival bleeding during brushing. As a result of received detailed history and the intraoral–extraoral examinations; retinal dystrophy, obesity, polydactyly, and renal defects of Caucasian female consistent with BBS were reported. Oral and dental findings were high-arched palate, crowding, and missing tooth. As dentists, we should know the diagnostic criteria of this syndrome. In addition, we should have a high index of suspicion so as to enhance the timely recognition of this condition. Dentists should also be familiar with the management protocol that includes a multidisciplinary approach to alleviate the existing conditions.

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Background: Hand hygiene (HH) is the single most important means of preventing hospital-acquired infections. We set out to determine the knowledge, training gaps, and practice of HH in a tertiary health institution in a resource constrained setting. Methods: This cross-sectional study was conducted among health care workers in a 600-bed capacity tertiary health centre. The study was conducted between April and November 2013. A multi-stage randomized sampling method was used to self-administer 322 WHO HH knowledge questionnaires. Information on HH training in the past 3 years, knowledge and practice of HH were obtained, and data were analysed using Epi-Info version 3.5.1. Results: A response rate of 98.5% was obtained for the HH knowledge assessment. Mean age of the study population was 39 ± 9.8. About 64% were females. Of all the respondents, only 16% had good knowledge of HH, 52% had moderate knowledge while 32% had poor knowledge. About 24% had formal training on HH. In terms of practice, only about 22% of the respondents self-reported routine practice of HH. Conclusions: The findings in this study suggest that there is sub-optimal HH knowledge, practice and training. It is imperative to improve the HH training and retraining of health care workers with a focus on attendants. Administrative controls and bold signage in healthcare institutions are also recommended.

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Introduction: Globally, nurses are known to care for hospitalized patients and the presence or absence of pressure ulcers is being regarded as a performance measure of quality nursing care. The study aims to determine the knowledge and practice of caregivers towards pressure ulcer prevention for hospitalized patients in National Orthopaedic Hospital, Enugu. Method: A cross sectional descriptive survey design was adopted among eighty-five (85) caregivers who met the inclusion criteria and participated in the study. Ethical approval and informed consent of participants was obtained before data collection using a pre-tested semi-structured questionnaire and checklist. Descriptive analysis and Chi-square statistical test was used to test for association between variables. Result: Results revealed poor knowledge 67.3% of pressure ulcer prevention among caregivers. Inadequate staffing 93.5%, heavy workload 92.9%, were highest perceived barriers to pressure ulcer prevention. The test of hypothesis showed that there is a significant relationship between years of service of caregivers and knowledge of pressure ulcer P = 0.000. Conclusion: It was concluded that in-service training, recruitment of more staff and ensuring availability of the necessary equipment are some of the important steps to improve nurses' knowledge and practice regarding prevention of pressure ulcer.

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Background: Initiation of oral intake after caesarean delivery influences return of bowel function, ambulation of patients, and time to recover from surgery. Aims: To assess the effect of early versus delayed initiation of oral feeding after caesarean delivery on gastrointestinal function, pace of recovery, and maternal satisfaction at University of Nigeria Teaching Hospital (UNTH), Enugu. Settings and Design: This was a randomized controlled study of women who had caesarean delivery from December 2012 to September 2013 at the Department of Obstetrics and Gynaecology UNTH, Enugu, Nigeria. In all, 282 participants were randomized equally into early and delayed oral feeding groups. Oral intake was commenced at 8 h post operation for those in early feeding group and at 48 h post operation for those in delayed feeding group. The primary outcome measure was the time interval from the end of surgery to the return of bowel sound. Subjects and Methods: Analysis was by intention-to-treat. SPSS version 16 was used for data entry and analysis was done using cross tabulation and Fisher's exact test for categorical data and independent sample T-test for continuous data. P value of <0.05 was regarded as statistically significant. Results: Apart from gastrointestinal complications, there was significant difference between early and delayed feeding groups with respect to all the outcome variables: return of bowel sound (17.8 ± 4.3 h vs 35.2 ± 9.4 h; P < 0.001), return to regular diet 48.9 ± 5.2 h vs 85.5 ± 7.0 h; P < 0.001), postoperative time interval to ambulation (20.3 ± 7.0 h vs 30.9 ± 9.6 h; P < 0.001), and maternal satisfaction as estimated with visual analog scale (86.4 ± 10.4 mm vs 40.0 ± 25.9 mm; P < 0.001). Conclusion: Early initiation of oral feeding after caesarean delivery is safe and may be associated with earlier return of bowel functions, earlier ambulation, shorter postoperative time interval to become eligible for discharge, and high maternal satisfaction.

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Objective: The aim of this study was to investigate how Queen bee syndrome, which is known as the mobbing behaviors of female employees from other female employees or managers, as perceived by nurses who are predominantly female workers. Materials and Methods: The universe of the qualitative type patterned research was formed by 12 nurses between the ages of 20 and 40 who worked for at least one year in different parts of a private hospital on the Anatolian side of Istanbul province. Maximum diversity sampling method for purposes was used for sample selection. The research data were collected in the form of written recording and voice recording with an unstructured interview form, which includes the structure, gender, competence, support, conflict, and competition themes created by the researchers to evaluate the characteristics of Queen bee syndrome. Focus group interviews were held on 30 April 2018. The results were evaluated using descriptive analysis and indicator methods. Results: In the study, the nurses' responses to interview questions were examined and women managers felt more emotional than men managers, and therefore they were less successful in problem-solving than men managers, but they were more successful in communication among women. The majority of nurses stated that women managers are more suitable for management in healthcare, that they are open to change, but they are not enough for men to solve the problem due to the fact that they are more concerned with the details. In addition, a significant part of the nurses, more than one female managers can cause competition and conflict in the workplace, especially women managers with similar status, said that this situation is seen more. Conclusions: The results of this study indicate that the woman is adapting to the Queen bee syndrome because of her ambition, competition, and emotional approaches, but that she has not been able to produce enough of it due to the environment.

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Background: The pattern of pediatric kidney diseases varies from one region to another because of genetic, racial, and environmental differences. This study was aimed at determining the pattern of renal diseases among children presenting at the pediatric nephrology clinic of the hospital. Subjects and Methods: It was a retrospective study of all children aged less than 15 years seen at the pediatric nephrology clinic of the hospital over a period of 30 months. The records of 244 patients seen at nephrology clinic over the period of study were retrieved and studied. Results: There were 155 males (63.5%) and 89 females (36.5%), with a male to female ratio of 1.7:1. The ages ranged between two months and 179 months, with a mean age of 104.8 ± 46.7 months. Nephrotic syndrome was the commonest renal disease and accounted for 33.6% (n = 82) of all cases, followed by acute glomerulonephritis with 25.8% (n = 63). Acute kidney injury and chronic kidney disease follow with frequencies of 34 (13.9%) each. The commonest congenital anomaly of the kidneys was ectopic kidney with 12 cases (4.9%). Conclusions: Our data reflects a high burden of renal diseases among children in our environment, and also reflects variations in regional patterns. The need for improvement of pediatric renal services and training of health workers in early detection and treatment of these conditions cannot be overemphasized.

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Background: This study was performed to evaluate the amount of apically extruded debris removed from a root canal filled with cold lateral condensation (CLC), and warm vertical compaction (WVC) techniques, using b or a phase gutta-percha with AH-Plus (Dentsply DeTrey, Konstanz, Germany) or Resilon (Resilon Research LLC, Madison, WI) with RealSeal SE (SybronEndo, Amersfoort, The Netherlands). Materials and Methods: About 100 human incisor teeth were prepared with a #25.06 NiTi rotary system and divided into five groups according to the filling material used: Group 1: CLC (gutta-percha, AH-Plus); Group 2: WVC (b phase gutta-percha, AH-Plus); Group 3: WVC (a phase gutta-percha, AH-Plus); Group 4: CLC (Resilon, RealSeal SE); and Group 5: WVC (Resilon, RealSeal SE). Extruded debris during the retreatment procedure was collected in preweighed Eppendorf tubes. The times required for retreatment were recorded. Results: The amount of debris extrusion was significantly greater with WVC than CLC in the gutta-percha and Resilon groups (P < 0.001). Using a phase gutta-percha resulted in significantly more debris extrusion than b phase gutta-percha (P < 0.001). In the WVC groups, Resilon caused significantly more debris extrusion than gutta-percha (P < 0.05). Retreatment was faster for CLC than WVC (P < 0.05). Conclusions: In the retreatment procedure, the amount of apically extruded debris and retreatment duration were dependent on the type of obturation material and technique used.

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Background: Hepatitis B virus infection is endemic in Nigeria, yet few data exist about the extent of infection in rural communities. Objective: To determine seroprevalence of hepatitis B surface antigenemia in two rural communities in Nigeria. Methods: A 330-person survey for seroprevalence of hepatitis B surface antigen (HBsAg) was carried out in two rural communities in Enugu State, Nigeria, in January, 2017. All study participants were screened for HBsAg using chromatographic immunoassay. Results: The mean age of participants was 57.2 ± 17.4 years, (range = 10–92 years) with 168 (50.9%) aged 60 years and above. The prevalence of HBsAg was found to be 2.1% with the 18–29 years age group having the highest prevalence. Conclusion: There is need to increase hepatitis B surveillance in rural communities to reduce transmission and institute early treatment.

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Background: An insufficient bone volume at the maxillary anterior region often restricts dental implant treatment and commonly leads to poor aesthetic outcomes. The defective site requires bone grafting as an initial surgical intervention before dental implant placement. In dental implantology, reconstructing osseous defects using autologous block bone grafts, biomaterials, or a combination of both is a routine surgical procedure. This study aims to evaluate the efficacy of autogenous, symphyseal, bone ring block grafts after the augmentation of defective sockets and clinical application of grafts in the maxillary anterior region with immediate insertion of a dental implant in a single surgical procedure. Materials and Methods: The study included eight patients (five females and three males) with 12 defective sockets. The technique included removing the bone from the chin region for transplant, fitting the three-dimensional bone rings in the prepared sockets of the maxillary anterior region, and screwing the dental implants through the rings. Patients underwent postoperative clinical examinations every day during the first week and then every month for 6 months. Results: In two cases, the wound dehisced but healed by secondary intervention during the follow-up period. In one case, the ring graft sequestrated because of infection in postoperative month 2, the osseous defect was reconstructed with biomaterials. The remaining cases healed with no infection, and no other case failed during the first year. Conclusion: This technique showed promising and advantageous results, and thus, could be an alternative treatment to other autogenous graft techniques, particularly for defective sockets.

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Paget–Schroetter syndrome (PSS), or effort thrombosis, refers to axillary and/or subclavian vein thrombosis associated with repetitive effort of the superior limbs, and is rare in the pediatric population. We report the case of a previously healthy 15-year-old boy who presented with a painful and swollen right arm after throwing firecrackers. Doppler ultrasound showed extensive right subclavian and axillary vein thrombosis. Anticoagulation therapy was started and had favorable evolution. We emphasize that PSS must be included in the differential diagnosis of a swollen arm.

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Objective: To investigate whether there is any relationship between the clinical parameters and the histopathological features of the gallbladder (GB) specimens obtained from living liver donors (LLDs). Methods: The demographic (age, sex, height, weight, and BMI), clinical (liver graft type, liver graft weight, and GB volume), microbiological (bile culture), and histopathological (width, length, wall thickness, and microscopic properties of the GB specimen) data of 169 LLDs, who underwent living donor hepatectomy between October 2015 and October 2017, were prospectively recorded and retrospectively analyzed. The LLDs were compared with respect to sex (male vs. female) and the histopathological features of the GB (normal structure vs. chronic cholecystitis vs. cholesterolosis/polyps/cholelithiasis). Results: There were no significant differences between both sexes with respect to age, graft type, and some features of GB (volume, wall thickness, width, length, and bile culture). On one hand, there were significant differences between both sexes with regard to height (P < 0.001), weight (P < 0.001), BMI (P < 0.001), histopathological findings (P = 0.003), and graft size (P = 0.003). Comparison with regard to GB's histopathological features revealed no significant differences between the three groups with respect to age, weight, and some features of GB (volume, length, width, and bile culture). On the other hand, the three groups were significantly different in terms of sex (P = 0.003), height (P = 0.008), BMI (P = 0.002), and wall thickness (P = 0.044). Bile culture proliferation occurred in none of the patients except for one patient. Conclusion: This study is the first to assess GB's volume, dimensions, and bile culture in healthy individuals such as LLDs.

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Background: Pterygomaxillary separation is the most critical step of Le Fort I osteotomy. Nonideal separation of pterygomaxillary junction could be associated with many complications. The purpose of this study was to evaluate the anatomic basis of proper pterygoid osteotome in Le Fort I surgery. Materials and Methods: The cone beam computed tomography image of 177 patients were evaluated retrospectively. To design an ideal osteotomy, the angle and the length of the posterior curvature of the maxillary sinus wall were measured. For the classification of the posterior angle as low, medium, and high, the category was based on upper and lower groups consisting of 27%, where the measurement and representability are at the maximum level. Results: The mean posterior length of three angle groups was as follows: low group: 7.81 mm, medium group: 7.54 mm, and high group: 7.41 mm. The differences were not statistically significant (P > 0.05). In addition, the posterior angle and length were evaluated according to the gender and the sides, and no statistically significant difference was found. (P > 0.05). Conclusion: Ideal osteotomy technique for pterygomaxillary disjunction and the avoidance of related complications could be achieved by selecting patient-specific osteotome using radiographic assessment.

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Background: Accurate assessment of the degree of dehydration is essential in the management and fluid therapy of dehydrated children. The invasiveness of central venous pressure limits its routine clinical use. Fortunately, some studies have suggested that ultrasonographic measurement of inferior vena cava (IVC) diameter: aorta diameter ratio (IADR) is an objective method of assessing intravascular volume. Objectives: To determine the clinical usefulness of ultrasound measurement of IADR in assessment of children with dehydration. Methodology: This was a cross-sectional study which compared dehydrated children to age- and sex-matched euvolemic healthy children as controls. The maximum anteroposterior diameter of the abdominal aorta (at peak systole) and maximum IVC diameter (in expiration) were measured. Results: A total of 120 subjects and 120 controls were evaluated. The mean age was 21.73 ± 20.89 months for subjects and 21.19 ± 22.13 months for control. The mean IADR for children with mild, moderate, and severe dehydration was 0.75 ± 0.07, 0.55 ± 0.07, and 0.33 ± 0.05, respectively. The mean IADR for controls was 0.99 ± 0.06. IADR had an inverse relationship with the degree of dehydration in the subjects. A cut-off point of 0.86, with a sensitivity and specificity of 96.7% in predicting dehydration, was derived, with the sensitivity and specificity increasing with increasing level of dehydration. Conclusion: IADR is sensitive and specific for assessing moderate and severe dehydration in Nigerian children.

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Background: Auto tricycle is an emerging common means of public transport in Nigeria. This study aimed to determine the scope and type of collisions and injuries from auto tricycles crashes in Nigeria, and identify potential areas for interventions to facilitate injury prevention. Patients and Methods: This was a prospective study of all the patients with auto tricycle injuries that visited Emergency rooms of three Nigerian tertiary hospitals from 1^st February 2015 to 31^st July 2016. Results: There were 210 victims; auto tricycle - other vehicle collisions, lone auto tricycle collisions and auto tricycle- pedestrian collisions accounted for injuries in 67.2%, 19% and 13.8% of them respectively. Preponderance of collisions at nighttime (60%), and on intra-city roads (86.7%) was observed. The rate of severe injury was significantly higher on inter-city than intra-city roads (32.11% vs. 9.3%, P < 0.001), and in daytime than night time (16.7% vs. 6.0%, P < 0.043). The lower extremity (50%), head (38.6%) and upper extremity (30.4%) were the three top anatomical regions involved. The case fatality rate was 1.4%: head injury accounted for two-third of the mortality. Conclusion: In Nigeria, auto tricycle has come to stay as a means of public transport and vulnerable road users are not immune to auto tricycle related injuries and its associated morbidity and mortality. This calls for preventive strategies, based on the findings in this study, which may curb the menace of auto tricycle crash and resultant injuries.

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Background: Primary and long-term implant stabilities are crucial in predicting the success of dental implants. We aimed to evaluate corticocancellous ratio (CCR) around virtual implant using cone beam computed tomography (CT) and assess its relationship with immediate and long-term stability of the implants placed. Materials and Methods: A total of 135 image records of posterior mandibular implant sites planned for dental implant were included in our study. CCR was calculated using CT images and implants were placed after stent preparation. Implant stability was calculated immediately, 4 months later, and 2 years later. Results: Pearson's correlation test showed a significant correlation (P and lt; 0.001) between CCR and implant stability. ANOVA and post-hoc Tukey tests showed a significant difference in implant stability between groups with different CCRs at all follow-up timepoints. No significant difference was found between mean implant stability quotient values for low CCR at 2-year follow-up and high CCR immediately after implant placement. Conclusions: Implant stability is improved with greater CCR. Cortical bone seems to be crucial factor for immediate and long-term stability of a dental implant. Virtual planning using CT can assess implant stability. Further histological studies are required to confirm the relation between CCR and implant stability. The escalating demand of the implant treatment in the dental practice necessitates measuring the several predictors of procedure success. This study introduces a novel predictor (CCR) around virtual implant for detecting the immediate and long-term stability of a dental implant.

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s Background: In this study, postoperative cardiac functions were observed in patients undergoing coronary artery bypass grafting (CABG) surgery following preoperative administration of the anti-ischemic drug trimetazidine. Materıals and Methods: The study included a total of 50 CABG patients; 25 were administered with trimetazidine preoperatively and 25 did not receive trimetazidine. A retrospective evaluation was made of the parameters of age, gender, preoperative echocardiography (ECHO) results, cross-clamping durations, postoperative inotropic requirements, and postoperative 4^th-h troponin-I levels and the groups were compared. Results: There was no statistically significant difference determined between the 2 groups in respect of the data of age, gender, comorbidity, preoperative ECHO signs [(ejection fraction (EF), left ventricle end systolic diameter (lvsd), left ventricle end diastolic diameter (lvdd), left atrium diameter (LA), and intraventricular septum thickness (IVS)], inotropic requirements, and postoperative troponin-I levels. In the control group, a positive correlation was determined between postoperative troponin-I levels and DM (r: 0.597, p: 0.002). There was no correlation determined in the trimetazidine group (r:-0.042, p: 0.844). Conclusion: The results of this study demonstrated a positive correlation between postoperative troponin-I levels and DM in the group not administered with trimetazidine. There was no such correlation determined in the group administered with trimetazidine. This result may suggest that DM may increase troponin-I levels in the absence of trimetazidine, and therefore that the drug may be cardioprotective in such cases. Further studies on more extensive patient populations are required to confirm these results.

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Ascher syndrome is a disease that is characterized by upper eyelid edema, double lip, and swelling in the thyroid glands whose etiology is unknown, and it is usually seen in young people over the age of 20. Blepharochalasis and double lip are observed in these patients as a result of the recurring lip and upper eyelid edema. The disease is benign and seen in both sexes and all races in about the same amounts. Although this syndrome rarely leads to functional problems, it usually leads to psychological problems in the patients it affects due to the malformations on their faces. In this case presentation, we reported the surgical treatment of a 27-year-old patient diagnosed with Ascher syndrome and displayed double lip based on this syndrome.

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Background: Dental implants and orthodontic mini implants or temporary anchorage devices (TAD) have been used for tooth replacement and as adjuncts to orthodontic treatment in anchorage control and retraction of segments of teeth respectively. They are manufactured from various materials with titanium being the currently used material. The patients in our environment have diverse cultural acceptances and constraints with some prohibiting the use of certain materials in their oral cavity. Aim: The aim of this study therefore was to determine the existence of cultural constraints in the use of dental or orthodontic min-implants and compare them in the management of patients. Materials and Methods: Four groups of dental patients were selected to determine if cultural constraints exist. Groups 1 and 2 were patients with either anterior or posterior missing teeth requiring replacement with dental implants (implant group) or partial dentures (denture group), respectively. Group 3 were orthodontic patients requiring TAD (orthodontic group) and group 4 were patients with other dental problems and served as the control (normal group). Associations between frequencies, gender, educational, and cultural differences were evaluated with the Chi-square test. Significant values of P < 0.05 were applied where applicable. Results: A total number of 192 participants were recruited for the study. Group 1 had the highest number of culturally constrained participants (n = 21, 10.9%). A significantly higher number from the group was seen (n = 11, 52.4%) among the African Traditional worshippers (ATR). Although a total number of 58 (30.2%) patients replaced their missing teeth, 37 (19.3%) utilized partial dentures in group 2 with no cultural constraints. Orthodontic implants were not rejected (n = 0, 0%) by all the four groups. Group 4 demonstrated a low level of constraints (n = 7, 4.2%). Of the four religious groups identified, ATR demonstrated the highest level of constraints with Christians and Muslims showing fewer constraints to the use of implants (n = 7, 33.3%) and (n = 2, 9.5%), respectively. Participants with the highest educational levels and social classes were more culturally constrained in the use of dental implants. Conclusion: Cultural constraints exist in the use of dental implants in our environment among African Traditional religion worshippers. There was, however, no cultural constraint to the use of orthodontic implants by any of the religious groups.

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Background: Non-communicable diseases (NCDs) are a major challenge to health and social development in the 21^st century, and North Korea is no exception. However, there is a lack of information concerning NCDs in North Korea, and a different approach is needed to understand the NCDs burden there. This study examines the perceptions and experiences of refugee doctors from North Korea concerning the NCDs burden in North Korea. Methods: Focus group discussions were conducted with 10 refugee doctors from North Korea who had been recruited through snowball sampling. Results: North Korean refugee doctors participating in this study indicated that NCDs are the highest priority diseases, that North Koreans did not appear to have a high level of understanding and knowledge of NCDs, that economic breakdown was the primary cause of the NCDs burden, and that a high priority should be assigned to targeting NCDs in North Korea. Discussion: Although the North Korean refugee doctors were medical professionals, they faced serious challenges accessing and managing patients with NCDs. South Korea needs to prepare for a potentially large number of people with NCDs should a freer movement of peoples occur between the two countries.

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Background: Health-seeking behavior is important as it reveals the preventive, curative, and rehabilitative actions taken by individuals to rectify perceived ill-health. Aim and Objectives: To identify existing eye health–seeking behavior, factors influencing such behavior, and suggest ways in which the system can respond to the needs of the target population in order to reduce visual impairment and blindness. Methods: This was a descriptive cross-sectional study; 600 respondents were interviewed using a semistructured pretested questionnaire administered to every fifth new patient attending the eye clinic of University of Calabar Teaching Hospital (UCTH) for a period of 5 months by a single interviewer. People unable to respond appropriately were interviewed alongside their caregivers. Results: Poor distant vision was the most frequent ocular complaint in this study. The mean duration of complaint before presentation to any health facility was 370.65 ± 889.48 days with a range of 0–9,125 days. Nature of eye complaint was the most significant factor that determined how early respondents sought help (P < 0.001). Place of residence, nature of eye complaint, and employment status were significant determinants of the choice of place of first presentation for ocular complaints. Conclusion: There is need for improved eye health education and awareness for prompt presentation to an appropriate eye care professional at the onset of symptoms and even case finding for potentially blinding eye conditions.

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