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2020| February | Volume 23 | Issue 2
Online since
February 7, 2020
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ORIGINAL ARTICLES
Attitude, practice orientation, benefits and barriers towards health research and publications among medical practitioners in Abia State, Nigeria: A cross-sectional study
GU Pascal Iloh, AN Amadi, OK Iro, SM Agboola, GU Aguocha, ME Chukwuonye
February 2020, 23(2):129-137
DOI
:10.4103/njcp.njcp_284_18
PMID
:32031085
Background:
Health research is an essential component of medical training, education, and practice and is fundamental in establishing the scientific basis of health care. Aim: The study was aimed at describing the attitude, practice, benefits, and barriers towards health research and publications in a cross-section of medical practitioners in Abia State, Nigeria.
Materials and Methods:
This was a cross-sectional descriptive study carried out on 210 medical practitioners in Abia State. Data collection was done using pretested, self-administered questionnaire that elicited information on attitude, practice, benefits, and barriers toward health research. Awareness of research misconduct, types of published research articles, and factors considered in selection of journals for publication of research were also studied.
Results:
The age of the participants ranged from 26 to 77 years. There were 173 (82.4%) men. The overall attitude toward research was moderate (
x
= 5.02 ± 0.96). All the respondents (100%) were involved in undergraduate research projects while 72 (34.3%) had at least one journal publication with the most commonly published articles being descriptive studies. The commonest barriers to research were financial and time constraints while the greatest benefits of research were advancement of medical knowledge and keeping practitioners abreast with evidence-based medicine. The commonest research misconduct was plagiarism while the most common factor considered in selection of journals for publication was article publication charges. Middle age group and years of practice more than 10 years were significantly associated with publication of journal articles (
P
< 0.05).
Conclusion:
This study has shown that the study participants had moderate positive attitude toward research with all the participants previously involved in undergraduate research and only one third had at least one journal publications. The commonest barriers were financial and time constraints and greatest benefits of health research was advancement of medical knowledge and keeping practitioners abreast with evidence-based medicine. Choice of journal for publications is preeminently determined by article publication charges. The most common article published and research misconduct was descriptive studies and plagiarism, respectively.
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Effect of psychosocial care model applied in an “elderly day care center” on loneliness, depression, quality of life, and elderly attitude
S Esmaeilzadeh, F Oz
February 2020, 23(2):189-197
DOI
:10.4103/njcp.njcp_366_19
PMID
:32031093
Background:
The purpose of the study is to evaluate the effect of the model applied in order to meet psychosocial care needs of elderly people in an elderly day care center on loneliness, depression, quality of life, and elderly attitude.
Method:
An intervention program prepared for the psychosocial needs of elderly people was carried out in the study and it was evaluated as pretest-posttest. The data were collected with UCLA Loneliness Scale (UCLA, LS), Geriatric Depression Scale Short Form (GDS-SF), Turkish version of the WHO Quality of Life Instrument Older Adults Module (WHOQOL-OLD-TR) and Turkish version of the WHO – Atittudes of Aging Questionnaire (AAQ-TR) in the study. The psychosocial intervention program was conducted once in a week, nine sessions were held in total and each of them took 90–120 min.
Results:
A statistically significant difference was found between the points that the elderly people obtained from the prior to and after UCLA Loneliness Scale and WHOQOL-OLD. TR instrument (
P
< 0.05). Besides, the difference between points gotten from the subdimensions “general,” “psychosocial loss,” and “psychosocial change” of AYTA-TR Scale was statistically significant.
Conclusion:
The intervention provided for the psychosocial needs of elderly people led to positive results in loneliness perception, quality of life, and elderly attitudes. Therefore, it is thought that this model is appropriate to be used commonly by nurses in psychosocial care of elderly people.
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C-shaped canal configuration in mandibular premolars and molars: Prevalence, correlation, and differences: An
In Vivo
study using cone-beam computed tomography
MH Mashyakhy, HR Chourasia, AH Jabali, HA Bajawi, H Jamal, L Testarelli, G Gambarini
February 2020, 23(2):232-239
DOI
:10.4103/njcp.njcp_335_19
PMID
:32031099
Aims:
To evaluate the prevalence, correlation, and differences of C-shaped canal morphology in mandibular premolars and molars by means of cone-beam computed tomography (CBCT).
Materials and Methods:
A total of 1433 mandibular premolars and molars CBCT scans from the Saudi population were evaluated. Axial sections of the roots were acquired at coronal, middle, and apical levels to evaluate C-shaped canals types. The prevalence, correlation, differences of C-shaped canals, bilateral/unilateral presence, gender differences, and location of external grooves on roots were assessed.
Results:
The prevalence of C-shaped canals in the first premolars was 1.5%, 0.80% in second premolars and 7.9% in second molars, whereas C-shaped canals were absent in first molars. No correlation was found between the presence of C-shaped canals within premolars and molars and between the two groups in the same individual. Both premolars and molars exhibited different types of C-shaped canals, C2 being predominant in premolars and C3 in second molars. Longitudinal external grooves were mostly located on mesiolingual (ML) surface in premolars and lingual in molars. Females showed more prevalence of C-shaped canals in second molars and no differences in premolars. Bilateral symmetry and unilateral presence in premolars and second molars were not significant.
Conclusions:
Although the prevalence of C-shaped canals is significantly higher in mandibular second molars, they are also found in mandibular premolars but in small percentages. No significant differences were found between both genders and both sides. Since they exhibit unpredictable morphology and differences across the root length, the use of small field CBCT is recommended when such anatomy is presented in a tooth indicated for root canal treatment for better management.
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Does Le Fort I osteotomy have an influence on nasal cavity and septum deviation?
A Atakan, AA Ozcirpici, H Pamukcu, B Bayram
February 2020, 23(2):240-245
DOI
:10.4103/njcp.njcp_355_19
PMID
:32031100
Aims:
Le Fort I (LI) osteotomy has been used for the correction of dento-facial deformities of the midface. The aim of this study was to determine the effects of advancement and impaction of the maxilla with LI osteotomy on the nasal cavity and septum.
Patients and Methods:
In this study, 40 adult patients, 23 females and 17 males (mean age 20.52 ± 4.4 years), who underwent single-piece LI advancement and impaction surgery combined with a bilateral sagittal split osteotomy (BSSO) were included. Posterior-anterior (PA) and lateral cephalometric radiographs taken before surgery (T0) and at least three months after surgery (T1) were evaluated. The superior and anterior movements of maxilla, changes of the nasal cavity, nasal septum and maxillo-mandibular parameter were measured on the cephalometric radiographs. Treatment changes were statistically analyzed using paired sample
t
-test, and Pearson correlation analysis was applied for the determination of the relationship between variables.
Results:
There was no statistically significant change in the deviation parameters (
P
> 0,05). However, a statistically significant decrease was found for left and right nasal cavity heights after LI osteotomy (
P
< 0.05). Furthermore, no significant correlation was found between septal deviation angle and extent of maxillary movement (
P
> 0.05). Positive correlation was found between nasal cavity width and amount of maxillary impaction. (
P
< 0.05).
Conclusion:
The influence of maxillary impaction with LI osteotomy on nasal septum deviation was not found significant but maxillary impaction with LI osteotomy significantly increased the nasal cavity width.
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Evaluation of long-term dental implant success and marginal bone loss in postmenopausal women
VE Toy, MO Uslu
February 2020, 23(2):147-153
DOI
:10.4103/njcp.njcp_295_19
PMID
:32031087
Aim:
The aim of this study was to examine long-term implant success and marginal bone loss (MBL) of dental implants in postmenopausal women with osteoporosis/osteopenia.
Materials and Methods:
Postmenopausal women who underwent dental implant treatment at least 3 years ago were divided into two study groups [Test (osteoporosis/osteopenia) Group and Control Group] according to bone mineral density (BMD) measurements. Besides clinical periodontal and radiographic examinations, any implant failures were also recorded.
Results:
A total of 52 patients with a mean age of 59.51 ± 5.66 years (Test Group; 26 patients, mean age: 60.61; Control Group; 26 patients, mean age: 58.42) were included in the study. Implant survival rates were 96.2% and 100% with a mean follow-up 60.84 ± 22.13 and 60.07 ± 20.93 months in Test and Control Groups, respectively (
P
> 0.05). While peri-implant PI (plaque index) and PD (probing depth) were not different between the groups, BoP (bleeding on probing) was significantly higher in Test Group (
P
= 0,026). Although MBL in Test Group was higher than Control Group (0.82 ± 0,63 mm and 0.44 ± 0,33 mm respectively), the difference was not found statistically significant (
P
= 0.069).
Conclusion:
Within the limits of this retrospective study, it can be concluded that postmenopausal osteoporosis/osteopenia does not affect MBL and long-term implant success. The findings suggest that dental implant therapy is a reliable treatment modality in these patients to improve the quality of life by increasing function and aesthetics.
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Changes in serological bone turnover markers in bisphosphonate induced osteonecrosis of the jaws: A case control study
S Demircan, SC Isler
February 2020, 23(2):154-158
DOI
:10.4103/njcp.njcp_374_19
PMID
:32031088
Background:
There are a lot study confirmed the relationship of bone serum markers changes and skeletal irregularities. But there is no sufficient case control studies about the role of these markers on bisphosphonate induced osteonecrosis of jaws (BRONJ).
Aims:
The aim of this study is to find out if there is any derangement of bone markers in bisphosphonate-treated patients with ONJ.
Methods:
We obtained serum bone markers and other relevant endocrine assays on 20 patients with osteonecrosis of the jaw (ONJ) and 20 randomized healthy volunteers. All of the ONJ group treated with zoledronic acid and had been withdrawn from bisphosphonate for at least 6 months. Diagnostic criteria for ONJ were those formulated by the American Association of Oral and Maxillofacial Surgeons. Serum levels of several indices of bone remodeling were evaluated using commercial enzyme-linked immunosorbent assays. The biochemical assays were performed on N-Telopeptides of type I collagen (NTX), bone-specific alkaline phosphatase (ALP), calcitonin, osteocalcin, intact parathyroid hormone (PTH), T3, T4, TSH, and Vitamin D 25 hydroxy (Vit-D).
Results:
In ONJ group, PTH level is statistically higher and TSH, Vit-D, osteocalcin and NTX levels statistically lower compared to control group.
Conclusion:
We conclude that these changes in PTH, Vit-D, TSH, osteocalcin and NTX levels maybe have a role in the pathophysiology of BRONJ. But the data need to be confirmed by future studies.
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408
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Comparison of postoperative pain after foraminal enlargement of necrotic teeth using continuous rotary system and reciprocating instrument: A randomized clinical trial
S Kurnaz
February 2020, 23(2):212-218
DOI
:10.4103/njcp.njcp_436_19
PMID
:32031096
Objectives:
This single-blind, randomized clinical trial (RCT) aimed to compare the duration, intensity, and incidence of postoperative pain after foraminal enlargement (FE) with continuous rotary systems and reciprocating instruments.
Materials and Methods:
Sixty qualified patients were randomly divided into the following two groups: the ProTaper Next group and the WaveOne group. Participants were selected from patients who had both asymptomatic necrosis and asymptomatic apical periodontitis with a single root canal. Endodontic treatment was performed in one visit, and the patients were asked to record their pain severity and analgesic consumption during a 7-day follow-up period using a visual analog scale (VAS). The data were analyzed using the Mann–Whitney
U
-test and Chi-square test (
P
< 0.05).
Results:
A significant difference was observed between the two groups during the first two days of follow-up (
P
< 0.05). Pain experience was higher in FEs that had been created by reciprocating instruments than by continuous rotary systems. There were no significant differences in VAS pain scores over the other days (
P
> 0.05). None of the patients had severe postoperative pain during the follow-up period. No significant differences were observed in the prevalence of analgesic consumption between either group (
P
> 0.05).
Conclusions:
This RCT indicates that in the 2-day follow-up period after endodontic treatment, FEs created by reciprocated instruments associated more postoperative pain than continuous rotary systems.
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441
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The effect of diode laser application on restoration of non carious cervical lesion: Clinical follow up
S Akarsu, SA Karademir, E Ertas, S Atasoy
February 2020, 23(2):165-171
DOI
:10.4103/njcp.njcp_399_19
PMID
:32031090
Aims:
The aim of this study is to evaluate the effect of the diode laser used for dentin sensitivity on the clinical success of non-carious cervical lesion (NCCL) restorations restored with different adhesive systems.
Methods:
20 NCCLs were restorated with Universal Single Bond (Self Etch) (3M, USA) and Grandio (Voco, Germany), 20 NCCLs were restorated with Universal Single Bond (Total Etch) and Grandio. After diode laser application, 20 NCCLs were restorated with Universal Single Bond and Grandio, 20 NCCLs were restorated with Universal Single Bond (Total Etch) and Grandio. The restorations were clinical evaluated by two examiners at baseline, for 6 and 18 months using modified United States Public Health Service (USPHS) Criteria. Chi-square test was used for statistical analyse.
Results:
The lowest rates of retention was found in the Group 1. There was no statistically significant difference among the groups in marginal discoloration, marginal integrity, sensitivity (
P
> 0.05).
Conclusion:
Diode laser application prior to the restoration of teeth with NCCL don't reduce the retention rate of restorations, may reduce hypersensitivity and may affect the success of restoration. However, further laboratory and clinical studies are required.
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Pulmonary hypertension in patients with end stage renal disease undergoing hemodialysis
M Tudoran, T Ciocarlie, A Mates, SA Pescariu, A AbuAwwad, C Tudoran
February 2020, 23(2):198-204
DOI
:10.4103/njcp.njcp_278_19
PMID
:32031094
Background:
Pulmonary hypertension (PH) is a serious cardiovascular complication in patients with end stage renal disease (ESRD) undergoing hemodialysis (HD) via arterio-venous fistulas (AVF).
Aim:
The aim of this study was to assess pulmonary vascular resistance (PVR), AVF flow volume (AVF-FV) and cardiac output (CO) and to highlight the impact of their augmentation, as well as of the duration of HD, on the occurrence of PH in patients with ESRD.
Methods:
Our study group consisted of 51 dialyzed patients, with ESRD, without history of PH. We determined by ultrasonography the systolic pulmonary arterial pressure (PAPs), the left ventricular ejection fraction (EF), the cardiac output (CO), PVR and AVF-FV.
Results:
We documented PH in 27 (52.94%) patients. All had elevated PVR, higher AVF-FV and CO comparing to patients without PH. They were undergoing HD for a longer period and had lower EF than those without PH. For all patients, we documented strong correlations between PAPs and PVR (r = 0.933,
P
< 0.001) and the duration of HD (r = 0.702,
P
< 0.001), but moderate ones with AVF-FV (r = 0.583,
P
< 0.001) and CO (r = 0.519,
P
< 0.001).
Conclusion:
In patients with ESRD undergoing HD, PH was a common finding being associated with increased PVR, a longer duration of HD and chronic glomerulonephritis as etiology for ESRD. The majority of patients with PH had altered left ventricular systolic function, predisposing them to an increased risk to develop heart failure.
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CASE REPORTS
Epithelial myoepithelial carcinoma of the parotid gland: A rare tumor with oncocytic changes
HC Inan, G Issin
February 2020, 23(2):266-269
DOI
:10.4103/njcp.njcp_296_19
PMID
:32031104
Epithelial myoepithelial carcinoma (EMC), a very rarely seen, low-grade, malignant, salivary gland tumor is most commonly located in the parotid gland followed by the submandibular gland. It is more often observed in females and in the 6
th
decade of life. Although primary treatment of the tumor is surgical resection, adjuvant radiotherapy may be applied to the adjacent area or close follow-up can be done if the surgical margin is closed. Patients must be followed up closely for recurrence and metastasis. Physical and radiological examinations (USG and MRI) should be performed to see for any recurrence in the operated area during the first year for every 2–3 months. This study presents the clinical, radiological, and pathological characteristics of a 59-year-old female patient with low-grade, oncocytic variant of EMC located in the left parotid gland.
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ORIGINAL ARTICLES
Evaluation of the relationship between appearances of the lingual foramen on panoramic radiography and cone-beam computed tomography
O Isman, S Kayar, D Surmelioglu, ME Ciftci, AM Aktan
February 2020, 23(2):205-211
DOI
:10.4103/njcp.njcp_377_19
PMID
:32031095
Aim:
The aim of this retrospective study is to determine the level of visibility of the lingual foramen in panoramic radiography using cone-beam computed tomography (CBCT) as a reference tool.
Method:
A total of 200 patients (111 females and 89 males) were included in the study. Cross-sectional CBCT images of the mandible in the midline were used to locate and define the orifice and diameter of each lingual canal that was detected. The appearance of the lingual foramen in the anterior mandible in panoramic radiography was assessed using a five-point ordinal scale. Descriptive statistics including tables and graphs were used. The correlation between CBCT and panoramic radiography findings were analyzed using Chi-square tests.
Results:
The lingual foramen was found to be located most frequently in the mandibular midline, above the genial tubercle (78.5%). A narrow-diameter type was found to occur most frequently (56.5%). A prominent genial tubercle was the most commonly found type (57.5%). The lingual foramen could be definitively identified in panoramic radiographs in only 8 cases (4%), while a high degree of probability was found in 25 cases (12.5%). The lingual foramen appears wider and therefore more distinctive in panoramic radiographs when the angulation of the lingual canal is less than 20° to the ground plane.
Conclusions:
Radiological evaluation with panoramic radiographs alone may lead to inadequate assessments prior to surgical procedures involving the anterior mandible. Clinicians may consider using three-dimensional imaging for procedures with a risk of hemorrhagic and neurosensory complications such as dental implant placement in the anterior mandible.
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Correlates of hopelessness in clinically stable nigerian adults with sickle cell disease
O Aloba, D Eyiolawi
February 2020, 23(2):219-225
DOI
:10.4103/njcp.njcp_119_19
PMID
:32031097
Objective:
Hopelessness is the most significant predictor of suicide among the clinical and nonclinical populations. The aim of this study is to examine the correlates and predictors of hopelessness among Nigerian adults with sickle cell disease (SCD).
Subjects and Methods:
Adopting a convenience sampling technique, 123 clinically stable SCD adult patients were selected from three hematological centers in Southwestern Nigeria. They completed a sociodemographic and illness-related questionnaire in addition to the Beck Hopelessness Scale (BHS), the Hospital Anxiety and Depression Scale (HADS), the 10-item Connor-Davidson Resilience Scale (CDRISC-10), and the Sickle Cell Self-Efficacy Scale (SCSES). The relationship between hopelessness and the other study variables was examined using correlational analysis (Spearman's rho). The extent of the variance these measures contributed to the score on the BHS was evaluated applying hierarchical regression analysis. The level of statistical significance was set at
P
value less than 0.05.
Results:
The mean age (years) of the participants was 25.38 ± 6.73 years. There were 68 (55.3%) females. The mean BHS score was 2.89 ± 3.30. Hopelessness had modest negative correlations with hemoglobin concentration (
r
= −0.366,
P
< 0.001), resilience (
r
= −0.483,
P
< 0.001), and self-efficacy (
r
= −0.318,
P
< 0.001), while modest positive correlations were observed with the HADS-Anxiety (
r
= 0.351,
P
< 0.001) and Depression (
r
= 0.530,
P
< 0.001) subscales. The hemoglobin concentration, resilience, and depression were the main predictors of hopelessness.
Conclusion:
Hopelessness among clinically stable Nigerian adults with SCD is significantly influenced by hemoglobin concentration and psychological variables (resilience and depression). These variables can serve as templates for the development of health promotion strategies (medical and psychological) aimed specifically at the amelioration of the severity of hopelessness within this population.
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Radiographic evaluation of bone density in dentulous and edentulous patients in Riyadh, KSA
MA Al-Attas, P Koppolu, SA Alanazi, KT Alduaji, PJ Parameaswari, LA Swapna, H Almoallim, P Krishnan
February 2020, 23(2):258-265
DOI
:10.4103/njcp.njcp_154_19
PMID
:32031103
Background:
The Cone Beam Computed Tomography (CBCT) is currently being used as the most common diagnostic method to evaluate the bone density of the maxilla and the mandible for planning dental implant. Aim: The aim of the study is to check the quantitative alveolar bone density in complete or partial edentulous and dentulous male and female patients among Riyadh sample population in Saudi Arabia.
Materials and Methods:
The study involved a cross-sectional analysis of 231 consecutive CBCT images of 231 different patients (115 males and 116 females). The scans were of Saudi National patients who were partially or completely edentulous without any bone infections in the maxilla and the mandible. The findings are presented as descriptive statistics and inferential statistics: student -t-test for two group means, ANOVA for three groups, Post-hoc LSD test for multiple comparisons, Levene statistics for testing the homogeneity of variances and a statistical significance at 5% level.
Results:
Comparison of mean alveolar bone density in maxillae of dentulous male smokers showed a statistically significant difference for bucco-cortical plate and cancellous bone among different regions. In dentulous male nonsmokers, no significant difference was observed for maxillary regions, while in mandibular areas, a statistically significant difference was seen for buccal cortex, palatal cortex, and cancellous bone among different regions. While studying the scans of female dentulous patients, a statistically significant difference was observed in alveolar bone density for all the areas.
Conclusion:
Evaluation of bone density is an important step in treatment planning and this study was aimed to provide insight into bone density patterns of population in Riyadh, Saudi Arabia. Further similar studies in different populations can help in planning for more efficient treatment outcomes.
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Postoperative analgesic effect of intrathecal dexmedetomidine on bupivacaine subarachnoid block for open reduction and internal fixation of femoral fractures
C Nwachukwu, HO Idehen, NP Edomwonyi, B Umeh
February 2020, 23(2):172-178
DOI
:10.4103/njcp.njcp_142_19
PMID
:32031091
Background:
One of the drawbacks of subarachnoid block is the short duration of analgesia particularly when adjuvants are not added to local anesthetics agent used. However, dexmedetomidine an α
2-
adrenergic agent has been found to possess analgesic effect.
Aims:
This study seeks to determine the analgesic efficacy of intrathecal 7.5 μg of dexmedetomidine and its side effects when used for open reduction and internal fixation (ORIF) of femoral fractures.
Methodology:
It is a prospective randomized, double-blinded study that was carried out in a Nnamdi Azikiwe University Teaching Hospital, Nnewi in Nigeria. Seventy American Society of Anesthesiologists I or II patients were randomized into two groups of 35 each to receive 3 ml of 0.5% hyperbaric bupivacaine combined with either 7.5 μg of dexmedetomidine in 0.3 ml of normal saline (Group D) or 0.3 ml of normal saline alone (Group S). Patient's outcome measures noted (time to first request of analgesia, proportion of patients with pain score <4 postoperatively using numerical rating scale [NRS], and total analgesic consumed in 24 h.).
Results:
The patients in Group D had a longer time to first request of analgesia, larger proportion of patients with pain score <4 using NRS in the 2
nd
h postoperatively and lower amount of total analgesic consumed compared to those in Group S. These differences between the two groups were all statistically significant. Furthermore, there was no difference in the incidences of side effects between the two groups (
P
> 0.05). However, the patient satisfaction was better in Group D.
Conclusion:
The addition of 7.5 μg of dexmedetomidine to bupivacaine for subarachnoid block in the management of femoral fractures using ORIF provided better anesthetic profile, particularly prolonged duration of postoperative analgesia without significant side effects.
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Prevalence of clinically significant antibodies in patients undergoing elective surgery in a Nigerian teaching hospital: A case for the type and screen method
EI Obi, OC Pughikumo, KI Korubo, AO Ejele
February 2020, 23(2):138-146
DOI
:10.4103/njcp.njcp_344_17
PMID
:32031086
Background:
Provision of safe and adequate blood is challenging in our environment due to paucity of voluntary donors as well as inappropriate blood ordering and utilization. The type and screen (TS) method (typing of blood group and screening for antibodies) reduces the demand for blood reservation in hospital blood banks.
Aims:
The aim of this study is to determine the safety (detection clinically significant antibodies) and cost effectiveness of the TS method compared to the conventional antiglobulin crossmatch (ACM).
Settings and Design and Methods:
This was a cross-sectional prospective study carried out at the University of Port Harcourt Teaching Hospital (UPTH). 124 participants booked for elective surgeries with no history of blood transfusion or pregnancy were investigated. ACM was performed on all participants' serum against 159 donor red cells. TS was also performed blindly on the same participants' sera, antibody screening was done with three-screen-cells using the gel method. An 11-cell panel was used for antibody identification. Blood utilization was calculated using the crossmatch: transfusion ratio (CTR), probability of transfusion (%T) and transfusion index (TI).
Results:
Out of the 159 units crossmatched for 124 study participants, only 19 were actually transfused (88.1% not utilized). The prevalence of compatible ACM was 100%, however the TS detected one antibody (0.81%) in a male participant identified as anti-M. The overall CTR, %T and TI were 8.4, 15.6% and 0.16 respectively, with N384,750 ($963.1) wastage in terms of cost. The TS method would have saved N266,000{$665.9} (N1900{4.78} per un-transfused patient).
Conclusions:
There was improper utilization of blood in elective surgeries. The TS method identified an antibody not detected by ACM. This would have saved N266,000 {$665.9}, and reduced the demand for blood reservation in the bank. Although The TS method was found not to be significantly different in outcome compared to the ACM, it was found to be cost effective.
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Oral health related qualıty of lıfe and dısease severıty ın autoımmune bullous dıseases
A Bilgic, F Aydin, P Sumer, I Keskiner, S Koc, S Bozkurt, G Mumcu, E Alpsoy, S Uzun, A Akman-Karakas
February 2020, 23(2):159-164
DOI
:10.4103/njcp.njcp_216_19
PMID
:32031089
Background:
There is an increased risk of long-term dental and periodontal disease in autoimmune bullous diseases (AIBD).
Aims:
In this cross-sectional study, we aimed to determine whether the oral health-related quality of life status (OHRQoL) was associated with disease severity and activity in patients with AIBD.
Subjects and Methods:
67 patients with AIBD were enrolled in this study. Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) was used to evaluate the disease severity. The score was categorized as a significant course (≥17) and moderate course (<17). Oral health impact profile-14 (OHIP-14) questionnaire was filled to assess the OHRQoL. Self-reported oral health status and oral lesion related pain score were also evaluated in the study group.
Results:
OHIP-14 score was significantly higher in active patients (42.28 ± 13.66) than inactive patients (29.08 ± 12.25) (
P
= 0.004) and it was correlated with the pain score (6.33 ± 2.78; r = 0.409,
P
= 0.013). Furthermore, OHIP-14 score was higher in patients with a significant disease course (45.18 ± 15.08) (
P
= 0.010) than in patients with a moderate course (36.09 ± 9.73).
Conclusions:
OHRQoL may be useful in the disease management and treatment. Since it can be affected by both presence of oral erosions and disease severity, a collaboration between dermatologists and dentists could be crucial to the disease management in AIBD.
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CASE REPORTS
Treatment of a case wıth gıant eyelıd syrıngomas
I Iritas, SY Iritas, PA Ozer, H Umudum
February 2020, 23(2):273-274
DOI
:10.4103/njcp.njcp_115_19
PMID
:32031106
He had a history of multiple asymptomatic flesh-colored papules, which had slowly increased in number and coalesced into plaques, on both upper and lower eyelids. Some of the plaques were giant and mostly coalescent in nature. We excised surgically the giant plaques which were approximately 1.5-2 cm in diameter symmetrically from upper and lower eylids and the remaining plaques were left to be treated with cauterization. Histopathological examination revealed syringoma. Both of the eyelids were observed to have a cosmetically adequate appearence after the surgical intervention.
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1,370
118
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ORIGINAL ARTICLES
Does regression in treatment-induced liver fibrosis reflect noninvasive tests? Assessing treatment results of hepatitis B patients who took potent antiviral drugs for 5 years
S Yalaki, MS Yalcin
February 2020, 23(2):226-231
DOI
:10.4103/njcp.njcp_7_19
PMID
:32031098
Background:
Chronic liver disease may be reversed through treatment, and it is crucial to have a definitive diagnosis of liver fibrosis for this treatment. Aims: In this study, we aimed to determine whether regression of liver fibrosis in naive patients undergoing strong antiviral therapy is reflected in noninvasive tests.
Materials and Methods:
We systematically reviewed and monitored medical records of patients with chronic hepatitis B who underwent liver biopsy for patient qualification. We selected patients with a liver fibrosis score of two or more who had not previously received antiviral treatment. We used previously described formulas to compute the indirect indicators of fibrosis for the patients and noted the values of Aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), age-platelet index (API), fibrosis index-based 4 factor (FIB-4), AST-platelet ratio index (APRI), mean platelet volume (MPV) and platelet count (PLT).
Results:
We found a significant difference between the three measurements for APRI, AAR and FIB-4 scores and MPV and PLT distributions in patients who were administered entecavir and tenofovir (Friedman
P
< 0.05). In the post-hoc binary comparison for both entecavir and tenofovir, we found significant differences between the baseline measurements and the 3
rd
- and 5
th
-year measurements in terms of APRI, AAR, FIB-4, MPV, and PLT.
Conclusion:
Liver biopsy is considered the gold standard for the treatment and follow-up of hepatitis B but may not be appropriate in all cases. Non-invasive tests may be effective in monitoring antiviral therapy. We demonstrated that non-invasive tests improved with antiviral therapy, which may be a reflection of treatment-regression in liver histopathology.
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1,127
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Evaluation of risk factors in pneumothorax development after computerized tomography-guided transthoracic biopsy and management of complications
M Kolu, IO Yildirim
February 2020, 23(2):246-251
DOI
:10.4103/njcp.njcp_541_18
PMID
:32031101
Aims:
This study aims to discuss the relationship between complications and patient characteristics and lesion properties in the transthoracic fine needle aspiration biopsy (TTFNAB) procedures performed for lung lesions and the treatment applied in our clinic to eliminate these complications.
Methods:
In this retrospective study conducted from July 2014 to August 2017, the CT-guided TTFNAB was performed on 186 patients (145 males, 41 females) who were considered to have malignancies on their clinical evaluation, CT, and PET CT results.
Results:
After 186 CT-guided TTFNAB interventions, a total of 24 (12.9%) patients developed procedure-related pneumothorax. Of these patients, 7 had a limited and minimal pneumothorax and no treatment was required for them, while 17 had a large and increasing pneumothorax and manual air aspiration was performed with coaxial needle during the procedure. The number pleural transitions (OR 6.513; 95%, 2,529-16,771
P
< 0.001), emphysematous lungs (OR 4.612; 95%, 1,852-11.487
P
< 0.001), and the presence of a lesion unrelated to the pleura (OR 8.205; 95%, 3,162-21,291
P
< 0.001) can form the basis for the development of a pneumothorax.
Conclusion:
The chances of developing pneumothorax after TTFNAB depend on number of pleural transition, emphysematous lungs, and non-pleural lesions. However, it is considered that procedures such as manual air aspiration and autologous blood patch may reduce the need for chest tube following the development of pneumothorax.
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1,048
157
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Profound approach to check legitimacy of an old technique used to gauge palatal rugae
B Gupta, S Gupta, M Jafer, F Quadri, AT Raj, S Patil
February 2020, 23(2):179-188
DOI
:10.4103/njcp.njcp_303_19
PMID
:32031092
Aims:
The present study aimed at assessing two fixed points of reference from where the mesial and distal point of all rugae can be measured so that the exact movement of particular rugae in any direction can be evaluated and assessing the changes in the palatal rugae after orthodontic treatment.
Methods:
A longitudinal study conducted among a sample of 20 (8 male and 12 female) adult patients. Pre- and post-orthodontic treatment casts of patients were obtained from the Department of Orthodontics College of Dentistry Jazan University. Antero-posterior linear distances (Technique I) between medial and lateral points of primary, secondary and tertiary rugae were measured. Also, the transverse linear distance (Technique II) between medial and lateral points of right and left rugae were measured. Technique III involved marking two fixed points and using these two points a third point is located on the medial or lateral end of rugae of right and left side in pre and post-treatment orthodontic casts. The independent sample
t
-test was employed to compare gender. Difference between the pre- and post-treatment mean values were checked by the paired
t
-test.
Results:
Technique III successfully showed the statistically significant difference (
P
≤ 0.05, 95% CI) in the overall pre and post-treatment values on the patients' cast (N = 20) which was not observed with a technique I and technique II.
Conclusion:
The triangle created by the three reference points in the technique III was able to identify the changes in the palatine rugae more precisely than the technique I and Technique II.
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131
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CASE REPORTS
Successful resolution of skin ulceration by itraconazole in an immunocompetent elderly patient
JY Shen, H Ding, J Zhou
February 2020, 23(2):270-272
DOI
:10.4103/njcp.njcp_245_19
PMID
:32031105
A 63-year-old patient was presented with faciocervical erythema and ulcers of 3 months duration. Pathological examination showed infiltration of inflammatory cells. Pathogenic microorganism cultivation was negative. However, empirical therapy with itraconazole proved effective.
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ORIGINAL ARTICLES
Is there a correlation between obstructive sleep-apnea syndrome severity and prolidase activity as an oxidative stress marker?
H Gunbatar, HS Kaplan, S Yildiz
February 2020, 23(2):252-257
DOI
:10.4103/njcp.njcp_381_18
PMID
:32031102
Objective:
Obstructive sleep apnea syndrome (OSAS) is a highly prevalent breathing disorder in sleep. The aim of this study was to evaluate the relationship between OSAS and prolidase activity, the oxidative stress index (OSI), total antioxidative capacity (TAC), total oxidative capacity (TOC) and the carotid intima media thickness (CIMT).
Method
: After night polysomnography, 74 people were diagnosed with OSAS and simple snoring. Plasma prolidase activities, TAC and TOC were measured in blood samples taken in the morning after the sleep study. The patients' bilateral common carotid arteries were scanned.
Results:
In total, 56 patients were in OSAS group [13 subjects 23.2% mild, 19 subjects 33.9% moderate, 24 subjects 42.8% severe] and 18 in simple snoring control group. The mean Prolidase, TOC, TAC and OSI levels were 744.7 ± 156.8, 59.2 ± 19.2, 2.12 ± 0.41, 3.12 ± 1.03, in the mild OSAS group, 761.6 ± 114.4, 57.9 ± 18.3, 2.03 ± 0.37, 3.15 ± 0.8, in the moderate OSAS group, 754.08 ± 133.9, 51.15 ± 12.1, 1.97 ± 0.27, 2.8 ± 0.82, in the severe OSAS group, and 711.9 ± 139, 52.3 ± 15.1, 1.83 ± 0.32, 3.06 ± 0.92 in the control group, respectively. Mean CIMT measurements were 0.71(±0,13) in the OSAS group and 0.76(±0.07) in the control group.
Conclusion:
There was no difference between the control and OSAS groups in terms of the parameters studied. Further studies should be undertaken in order to clarify the relation.
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Medknow
Online since 10
th
November, 2010