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2022| March | Volume 25 | Issue 3
Online since
March 16, 2022
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ORIGINAL ARTICLES
Association of frontal and maxillary bone fractures and concomitant craniocerebral injuries in patients presenting with head trauma
G Orhan Kubat, C Sahin, O Ozen
March 2022, 25(3):342-348
DOI
:10.4103/njcp.njcp_1582_21
PMID
:35295058
Background:
Maxillofacial fractures and craniocerebral injuries are common in patients with head trauma. These are injuries with high mortality and morbidity. Therefore, patients with head trauma should be evaluated early with a multidisciplinary approach.
Aim:
The association between frontal and maxillary bone fractures and concurrent craniocerebral injuries were investigated in patients presenting with head trauma in this study. The data of the patients were analyzed retrospectively.
Methods and Material:
Age and gender distributions were evaluated in frontal and maxillary fractures. Concomitant craniocerebral injuries were investigated. Craniocerebral injuries were grouped as pneumocephalus, extra-axial, intra-axial injuries and brain edema. Craniocerebral injuries in frontal and maxillary fractures were compared statistically.
Results:
Frontal bone and maxillary bone fractures were detected in 24% and 95% of the patients. Coexistence of pneumocephalus and intra-axial injuries in frontal bone fracture was statistically significant. The association of frontal posterior wall fractures with pneumocephalus and parenchymal contusion was found to be statistically significant. In addition, the association of craniocerebral injuries were evaluated and statistically significant ones were determined.
Conclusion:
The presence of maxillofacial fractures in patients presenting with head trauma increases mortality and morbidity. Craniocerebral injuries can be life-threatening and delay the treatment of facial fractures. Upper facial bone fractures are significantly more common in craniocerebral injuries.
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Barriers and solutions to effective mentorship in health research and training institutions in Nigeria: Mentors, mentees, and organizational perspectives
MD Ughasoro, A Musa, A Yakubu, BO Adefuye, AT Folahanmi, A Isah, A Onyemocho, EE Chukwu, CU Chukwudi, JN Dadi Mamud, E Effa, HO Egharevba, A Etokidem, AN Mbachu, AR Njokanma, AA Ogunfowokan, NE Ohihoin, C Onwuamah, TA Orunmuyi, AO Salako, AA Yusuf, N Okubadejo, J Anepo-Okopi, O Ezechi, BL Salako
March 2022, 25(3):215-225
DOI
:10.4103/njcp.njcp_154_20
PMID
:35295040
Aims and Background:
Mentoring relationships and programs have become a subject of global interest and their relevance is high in the ever-evolving health system. In Nigeria, informal system of mentoring is largely practiced. To be able to institutionalize mentoring program, there is need to explore the various challenges of mentoring process and suggest potential approaches for effective mentor-mentee relationship in health research institutions in Nigeria.
Subjects and Methods:
The study was designed to explore the barriers and solutions to mentoring process from the perspectives of the mentor, mentee, and organization in health research and training institutions in Nigeria. A cross-sectional descriptive design was employed and the study was conducted among 21 health researchers drawn from 24 health research institutions across the 6 regions of Nigeria. The nominal group technique was adopted in the data collection process.
Results:
The most frequently reported mentor challenges were “lack of understanding of mentorship process” (84.2%) and “lack of capacity for mentoring” (78.9%), while those of mentee were “mentor preference” (73.7%) and “lack of freedom of expression” (47.4%). “Culture of selfishness/individualism” (84.2%) and “lack of formal relationship” (63.2%) were the most mentioned systemic challenges. Training on mentoring process and relationship was mentioned as the most frequent approach to overcoming challenges for the three perspectives.
Conclusion:
Significant mentorship challenges exist in the Nigerian health, academic and research institution. Systematic approaches to finding and implementing the appropriate solutions are needed to circumvent these bottlenecks.
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Evaluation of iron status in anemic pre-dialysis chronic kidney disease patients
B Waziri, BT Babawale, MO Mabayoje
March 2022, 25(3):226-230
DOI
:10.4103/njcp.njcp_234_19
PMID
:35295041
Background:
Data on iron status are generally less readily available in pre-dialysis chronic kidney disease (CKD) patients than in the hemodialysis population. In Nigeria, little is known about iron indices in patients with CKD.
Aims:
The aim of this study was to evaluate the iron status among anemic pre-dialysis patients with CKD.
Patients and Methods:
Using a cross-sectional study design, we evaluated serum ferritin and transferrin saturation (TSAT) among 63 pre-dialysis CKD patients with anemia attending our outpatient nephrology clinic. CKD was defined as a glomerular filtration rate less than 60 ml/min/1.73 m
2
for 3 months or more, while anemia was defined as a hemoglobin concentration (Hb) less than 11 g/dl.
Results:
The mean age of the study participants was 52.5 ± 12.7 years and 33 (52.4%) of the patients were females. The most common causes of CKD were hypertension (44.4%) and diabetic nephropathy (30.6%). The mean Hb, mean serum ferritin, and mean TSAT were 9.2 ± 1.1 g/dl, 106.6 ± 72.7 ng/ml, and 24.3% ± 7.9%, respectively. There was no significant difference in median ferritin (91[interquartile range: 54-133] ng/ml versus 106 [interquartile range: 45-151;
P
=0.75) and mean TSAT (24.9 ± 7.2 % versus 23.8 ± 7.7 %;
P
=0.54) between male and female study participants; Half (50.8%) of the study participants had absolute iron deficiency (serum ferritin <100 ng/ml) and 6.3% had functional iron deficiency (ferritin >100 ng/ml and TSAT <20%).
Conclusion:
Iron deficiency is common among anemic adult Nigerian pre-dialysis CKD patients. Results of iron studies should guide therapy when correcting anemia in these patients.
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Comparison of factors affecting patients with a myofascial temporomandibular disorder with and without sleep bruxism
A Tuncer, F Atay, HC Guzel, AH Tuncer
March 2022, 25(3):273-280
DOI
:10.4103/njcp.njcp_1420_21
PMID
:35295048
Aims and Background:
The aim of the present study was to evaluate the relationship between jaw function, neck disability, sleep quality, fatigue, and headache in patients with myofascial temporomandibular disorder (TMD) with sleep Bruxism (SB) and without it (non-SB).
Subjects and Methods:
This case-control study was conducted with a total of 200 myofascial TMD patients, comprising 91 identified as SB and 109 as non-SB. The Jaw Function Limitations Scale (JFLS), Neck Disability Index (NDI), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), and Headache Impact Test-6 (HIT-6) scales and indexes were used.
Results:
In the group with SB compared to the non-SB group, JFLS, NDI, PUKI, and FSS scores were statistically significantly higher (
P
< 0.001). No statistically significant difference was found between the groups in terms of visual analog scale (VAS) (
P
= 0.127) and HIT-6 scores (
P
= 0.365). The probability of having JFLS in patients with SB compared to those without was folded 3.551 times (
P
= 0.002), and the probability of having NDI increased 3.473 times (
P
= 0.002). In addition, SB was observed to trigger poor sleep quality (
P
< 0.001). There was no statistically significant determinant of bruxism on FSS (
P
= 0.196), and on HIT-6 (
P
= 0.488).
Conclusion:
It can be concluded that SB causes limitation of the jaw's functional activities, neck problems, and decreased sleep quality in myofascial TMD. These findings emphasize the importance of considering SB when evaluating and treating patients with myofascial TMD problems.
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Gastric intestinal metaplasia: Long-term follow-up results
H Rakici, E Uyanik, IM Rakici, HB Polat, RA Akdogan, G Aydin, MA Ayvaz, R Bedir
March 2022, 25(3):315-324
DOI
:10.4103/njcp.njcp_1548_21
PMID
:35295055
Baackground:
Precancerous lesions are the most commonly cited factor in gastric cancer etiology. The sequence of events in intestinal-type gastric carcinogenesis is considered to be chronic gastritis, atrophy, intestinal metaplasia (IM), dysplasia, and carcinoma, respectively. Early diagnosis and treatment of advanced precursor lesions and gastric cancer is possible by identifying and monitoring patients with such premalignant lesions.
Aim:
In our study, we aimed to evaluate the long-term follow-up results of intestinal metaplasia in our hospital and the rate of progression to malignancy by comparing these patients with patients who have undergone gastroscopy without a diagnosis of intestinal metaplasia.
Material and Method:
One hundred and fifty-six followed-up patients out of 700 between the ages of 18 and 85 who were admitted to our hospital between 2009 and 2019, who were diagnosed with IM by pathological examination from biopsy material, and 150 patients who were not diagnosed with IM between 2009 and 2011 were included. The results of the cases were evaluated first retrospectively; then, the patients who were invited for control and underwent endoscopy were evaluated prospectively. IM and control groups were compared in terms of dysplasia and gastric cancer development. In addition, the IM group was compared in terms of 5 and 10 years of follow-up, extensive or local involvement, and complete and incomplete involvement in terms of dysplasia and cancer development.
Results:
The follow-up period of the patients ranged from 1 to 10 years, and the mean follow-up interval was 4.2 ± 2.8 (min: 1; max: 10) years. Age, gender, and pathology results of the patients were examined in terms of IM type, localization of IM, pathology accompanying IM, and presence of Helicobacter pylori (Hp) infection and compared with the control group. While gastric carcinoma was detected in three of 156 patients in the IM group, gastric carcinoma was not detected in the follow-up of 150 patients in the control group. IM was most common in the antrum. Incomplete IM was detected in 89 patients, and complete IM in 69 patients. While two of the three patients with gastric carcinoma were localized to the antrum, one patient had incomplete-type IM and two patients had complete-type IM, and Hp was positive in two patients. While dysplasia was detected in nine of the patients diagnosed with IM, it was detected in two patients in the control group. A statistically significant difference was found between the IM and control groups in terms of dysplasia positivity (p = 0.037). On the other hand, no statistically significant difference was found between the IM and control groups in terms of age-group, gender, follow-up time group, and Hp positivity (p > 0.05). There was no significant difference between those who were followed up for 5 and 10 years in the IM group in terms of dysplasia and cancer development.
Conclusion:
Therefore, it is considered that patients with intestinal metaplasia may be followed up at longer intervals, except for patients with race, ethnicity, incomplete type, extensive involvement, and a family history of gastric cancer.
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Compressive strength, surface roughness, and surface microhardness of principle tricalcium silicate-based endodontic cements after universal adhesive application
K Olcay, MB Guneser, AN Dincer, HM Uyan
March 2022, 25(3):231-238
DOI
:10.4103/njcp.njcp_1287_21
PMID
:35295042
Aims and Background:
It was aimed to evaluate compressive strength (CS), surface roughness, and microhardness of mineral trioxide aggregate (ProRoot MTA) and Biodentine (BD) after adhesive application.
Materials and Methods:
Tests was carried out according to international ISO standard. ProRoot MTA and BD were prepared in Teflon molds according to manufacturer's instructions:
n
= 210 for CS;
n
= 210 for microhardness. Samples were incubated for 7 days at 37°C in 100% humidity. Surfaces were smoothed with up to 2000 grits of silicon-carbide sandpaper on abrasive device at 150 rpm, randomly divided into seven groups (
n
= 15). Clearfil Universal Bond, All Bond Universal, and Single Bond Universal (SBU) were applied in both total-etch and self-etch (SE) modes. Adhesives were applied according to manufacturers' recommendations (no adhesive used in control). CS was performed at speed of 1 mm/min, microhardness at 100 gr for 15 s. The surface roughness of the samples was analyzed with atomic force microscopy. Two-way analysis of variance and
post hoc
Tukey tests were used for the evaluation of the data.
Results:
Man CS and microhardness values between ProRoot MTA and BD were as follows: 24.9 N, 72.6 HV; 59.8 N, 59.0 HV, respectively. In CS, BD was higher than ProRoot MTA (
P
< 0.05). In other comparisons except for SBU SE group (
P
< 0.05), BD and ProRoot MTA showed similar results (
P
> 0.05). However, ProRoot MTA was found higher than BD regarding microhardness (
P
< 0.05). As a result of the adhesive application in both BD and ProRoot MTA groups, a decrease in surface roughness was observed compared to the control group.
Conclusion:
BD exhibited better results than ProRoot MTA regarding CS. However, ProRoot MTA was found to be more successful than BD in terms of microhardness. BD and ProRoot MTA showed similar physical properties in terms of surface roughness. To improve regenerative procedures, besides the selection of bioceramic cements, the interaction between cements and materials applied during coronal restoration should be considered.
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Prevalence and risk factors associated with dry eye disease among adults in a population-based setting in South-West Nigeria
AO Betiku, OO Oduyoye, OO Jagun, OS Olajide, SO Adebusoye, UO Aham-Onyebuchi
March 2022, 25(3):354-360
DOI
:10.4103/njcp.njcp_1598_21
PMID
:35295060
Background:
Dry eye disease (DED) occurs as a result of an abnormality in tear production, tear consistency, and tear evaporation.
Aim:
The aim of this study is to determine the prevalence and risk factors associated with dry eye disease in a population-based setting in Southwest Nigeria.
Patient and Methods:
A cross-sectional study was conducted at a medical outreach at Iperu Remo in Nigeria. A systematic random sampling technique was used to select 415 participants. Symptoms of dry eye were evaluated using the Ocular Surface Disease Index questionnaire. Tear film break-up time (TBUT), fluorescein staining, Schirmer test with anesthesia, and meibomian gland were evaluated. The diagnosis of DED was confirmed when the OSDI score is ≥13 and TBUT is less than 10 seconds. Data were analyzed using descriptive statistics, Chi-square, and logistic regression analyses at a 0.05 level of significance.
Results:
The overall prevalence of DED was 28.2%. Adults aged between 31 and 40 years were 23 times more likely to be diagnosed with dry eyes (aOR = 23.13; 95% CI: 1.32 – 405.99;
P
= 0.032) compared to those between 16 and 20 years. Female adults were about four times more likely to be diagnosed with dry eyes (aOR = 3.59; 95% CI: 1.44 – 8.94;
P
= 0.006). The use of drugs was also significantly associated with dry eyes.
Conclusion:
This study shows a fairly high prevalence of DED among adults in a semi-urban area in Southwest Nigeria. Ophthalmologists and other eye care workers need to be cautious about the DED and offer appropriate treatment options to patients.
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1,435
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Differences in hard and soft tissue profile after orthodontic treatment with and without extraction
A Alqerban, A Alaskar, M Alnatheer, A Samran, N Alqhtani, P Koppolu
March 2022, 25(3):325-335
DOI
:10.4103/njcp.njcp_1562_21
PMID
:35295056
Aims and Background:
Premolar extraction is often associated with variations in the soft tissue profile that lead to considerable improvements in the facial profile. This study compared the changes in the facial profile of hard and soft tissues and investigated possible differences in the various facial parameters between patients who were treated with and without premolar extraction.
Materials and Methods:
A total of 98 orthodontically treated patients were divided into two groups with an equal number of participants. Premolar extraction was performed in the test group only. A total of 33 landmarks were identified on each cephalometric radiograph. The intraclass correlation coefficient was calculated. We evaluated changes in measurements between pre- and post-treatment by performing the signed-rank test. We used the Kruskal–Wallis test to compare changes between the groups.
Results:
No significant differences were observed in the treatment outcomes of skeletal and soft tissue variables in class I and class II participants between the test and control groups (
P
> 0.01). However, significant differences were noted in the treatment outcomes of dental variables in class II participants between the groups. Dental variables did not show any significant difference in class III patients between the groups.
Conclusion:
This study showed that skeletal and soft tissue changes were similar in skeletal except for few dental parameters following orthodontic treatment with and without premolar extraction.
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CASE REPORTS
Asymptomatic chronic-phase chronic myeloid leukemia BCR-ABL. (+) without splenomegaly: A case report
W Rajabto, YK Angkasa
March 2022, 25(3):373-375
DOI
:10.4103/njcp.njcp_1401_21
PMID
:35295063
Chronic Myeloid Leukemia (CML) is one of the myeloproliferative disorders characterized by Philadelphia chromosome presence. Contrary to Western countries, most CML patients in Indonesia present symptoms with splenomegaly as the most common finding. It is rare to find asymptomatic CML patients. We present a case of asymptomatic chronic-phase chronic myeloid leukemia BCR-ABL (+) without splenomegaly who achieved a hematologic and molecular response to imatinib.
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ORIGINAL ARTICLES
SOCS-1 1478 CA/del gene polymorphism affects survival in colorectal carcinoma
T Ayyildiz, E Dolar, B Oral, B Erturk, A Eroglu Haktanir, SB Adim, O Yerci
March 2022, 25(3):239-247
DOI
:10.4103/njcp.njcp_1309_21
PMID
:35295043
Aims and Background:
Suppressor of cytokine signaling 1 (SOCS1) is a prototype molecule of the SOCS family. Alterations in the SOCS1 expression have been reported in human cancers and some studies suggest that SOCS1 might act as a tumor suppressor in carcinogenesis. In the present study, we aimed to evaluate the association of SOCS1 promoter -1478CA/del gene polymorphism detected in DNA isolated from the tissues of patients with colorectal cancer (CRC) for histopathological characteristics and survival.
Patients and Methods:
For the study, we retrospectively enrolled 53 patients with resected colon due to CRC and 23 control subjects with no systemic illness. SOCS1- 1478CA/del gene polymorphism was determined using the polymerase chain reaction-restriction fragment length polymorphism methodology. These results were evaluated in relation to histopathological features and survival results and analyzed statistically. A
P
value equal to or less than 0.05 was considered significant.
Results:
Neither control subjects nor the CRC group showed a significant association with SOCS1 -1478CA/del gene polymorphism (p = 0.248). SOCS1 -1478CA/del gene polymorphism was not significantly associated with histopathological features either. However, in the overall survival (OS) analysis, those patients with the del/del allele were found to have a 3.9-fold greater risk of mortality compared to those with CA/CA allele (p = 0.05). Progression-free survival (PFS) was also significantly different in such patients (p = 0.05).
Conclusion:
The present study examining the association of SOCS1 -1478CA/del gene polymorphism with CRC showed that CRC patients with del/del allele had both significantly shorter PFS and OS versus those with CA/CA or CA/del allele.
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Hematuria frequency and association with abnormal urological findings in medical check-up patients
M Sarier, M Demir, M Emek, H Turgut
March 2022, 25(3):310-314
DOI
:10.4103/njcp.njcp_1509_21
PMID
:35295054
Aims and Background:
Hematuria is one of the most common findings in urology. The management of hematuria detected in routine medical check-ups is also important in this respect. The aim of this study was to determine the frequency of hematuria in patients undergoing medical check-ups and evaluate its association with abnormal urological findings in laboratory tests and imaging.
Patients and Methods:
Asymptomatic patients who presented to the check-up clinic between January 1 and December 31, 2020, were included. All patients underwent a complete laboratory workup and total abdominal ultrasound (TAUS). The distribution of hematuria by sex and age and the relationship between hematuria and abnormal urological findings in the laboratory tests and TAUS were calculated.
Results:
The mean age of the 2,077 check-up patients was 45.8 ± 12.8 years. The female to male ratio was 1.07:1, and there was no significant difference in age between the sexes (
P
= 0.655). Microscopic hematuria was detected in 15.9% of the patients. The frequency of hematuria was 10.8% in men and 20.7% in women (
P
< 0.001). Men with hematuria were significantly older than men without hematuria (
P
= 0.033), whereas hematuria was not associated with age in women (
P
= 0.521). When its relationship between abnormal urological findings was evaluated, hematuria had a sensitivity of 21.70% (95% confidence interval [CI]: 18.84, 24.86) and a specificity of 87.11% (95% CI: 85.23, 88.79).
Conclusion:
The frequency of hematuria in check-up patients was remarkable, at 15.9%. Hematuria in women is more common and unrelated to age, unlike in men. Hematuria had a high specificity but low sensitivity for urological abnormal findings.
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Correlating optical coherence tomography biomarkers with visual acuity in nigerian retinitis pigmentosa patients
ON Okonkwo, AO Hassan, EN Ogbedo, T Akanbi, V Umeh, CT Agweye
March 2022, 25(3):267-272
DOI
:10.4103/njcp.njcp_1312_21
PMID
:35295047
Background:
Spectral Domain Optical Coherence Tomography (SD-OCT) has been used for imaging retinitis pigmentosa (RP) eyes and provides useful information on microstructural changes.
Aim:
To review SD-OCT findings and correlate the central foveal thickness (CFT), outer nuclear layer (ONL), external limiting membrane (ELM), and ellipsoid zone (EZ) with visual function in nonsyndromic RP eyes.
Patients and Methods:
A multicenter, retrospective review of records from consecutive eyes diagnosed to have RP. Biodata, systemic disease, visual acuity, lens status, intraocular pressure, and SD-OCT images were examined. The CFT was categorized into normal (250–299 microns), atrophic (0–249 microns), and edematous (≥300 microns). The ONL, ELM, and EZ within the subfoveal area was assessed and rated as normal, reduced (if less than normal), or absent (if missing). The status of these biomarkers was correlated with visual acuity and statistical analysis performed using Pearson Chi
2
,
P
< 0.05. In addition, the vitreomacular interface was examined for the presence of vitreomacular traction (VMT), vitreomacular adhesion (VMA), and epiretinal membrane (ERM).
Results:
Fifty-two RP eyes of 27 patients had SD-OCT images that were used for study analysis. There were 17 males and 10 females; 52% of participants were between 31 and 50 years (age range: 22–77 years). An atrophic retina was the most common finding in 42 eyes (81%); the average CFT in the atrophic group was 175 microns (range: 111–245 microns). There were three eyes with cystoid macular edema, and seven eyes were normal. For the OCT biomarkers, a reduction in ONL and ELM occurred in 69% and 46% of eyes, respectively, while an absence was the most common EZ finding (in 50% of eyes). There was a significant correlation between the presence or absence of the three biomarkers and presenting vision: ONL, ELM, and EZ with
P
values of 0.000, 0.006, and 0.011, respectively. The CFT had no significant correlation with vision;
P
= 0.522. Other findings on OCT include ERM 17%, VMA 6%, and VMT 2%.
Conclusion:
This report supports the notion that OCT image reporting on physical retinal structure in RP eyes can be used to predict disease effects on vision. A prospective study to better quantify the degree of structural change and correlate with the degree of functional loss is required for RP gene types in Nigerians and black Africans.
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The effect of erosive beverages and polishing systems on the surface properties of nanohybrid composite resin
B Ozdemir, N Ozakar Ilday, SB Ozdemir, F Suleyman, Z Yesil Duymus
March 2022, 25(3):248-254
DOI
:10.4103/njcp.njcp_1361_21
PMID
:35295044
Aims and Background:
The aim of this study is to evaluate the surface microhardness and roughness of composites treated with three different polishing systems exposed to two different corrosive beverages.
Material and Methods:
Ninety-six composite resin disks were randomly divided into four groups, one of which was the control group. The surface roughness and microhardness values were measured after 24 h in the polishing process. The samples were divided into three subgroups and kept in distilled water, cola, and ice tea for 20 min a day for 14 days. Then, the roughness and microhardness measurements of the samples were taken again. Two samples randomly selected from each group were examined using a scanning electron microscope (SEM) and analyzed statistically using the two way anova (ANOVA) and Duncan tests.
Results:
A statistically significant difference was found between the roughness and hardness values at the end of 24 h and 14 days. Onegloss (OG), Dentoflex (DF), and Super-snap (SNP) polish systems showed the highest roughness in the cola group, respectively. Microhardness values: The unpolished group had the lowest significant microhardness in the coke group (
P
< 0.05).
Conclusion:
In this study, it was seen that the lowest success rate was the OG polishing system.
[ABSTRACT]
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3D assessment of facial contours of patients wearing either complete denture or implant-supported fixed dentures
ZB Demirekin, A Gunaydin, K Cavdarli, Y Findik, S Turkaslan, T Baykul
March 2022, 25(3):286-293
DOI
:10.4103/njcp.njcp_1446_21
PMID
:35295050
Background:
Total edentulousness leads to soft tissue changes causing esthetic problems. Being aware of the significant effects of different treatment approaches on facial soft tissue can help to obtain more satisfying esthetic results.
Aim:
The current study's objective was to evaluate three-dimensional facial soft tissue changes in edentulous patients rehabilitated with a complete denture (CD) and implant-supported fixed partial denture (FPD).
Material and Methods:
Fourteen edentulous patients, mean age of 47.6 years (42–63), were assessed before prosthetic treatments (T0), after CD (T1), and after FPD (T2). 3dMDface System (3dMD LLC) obtained the images and transferred them to 3dMD Vultus software (3dMD Vultus software Version 2.3.0.2). Nine linear, five angular, and one topographical measurement were performed for facial soft tissue analysis. For statistical analysis of facial soft tissue, ANOVA was used with a level of significance set at 5% (p <.05).
Results:
Significant differences were observed in lower lip height (Sto-Sl) and nasolabial angle (Prn Sn Ls) with CD. There is no significant difference with the implant-supported fixed partial dentures in these measurements when compared with pretreatment. Significant differences were observed in the lower lip angle (Chr Li Chl) with the implant-supported fixed partial dentures. There is no significant difference with CD in this measurement when compared with pretreatment. According to the paired comparisons, a significant difference was observed in philtrum height (Ls-Sn) between the treatment approaches.
Conclusion:
CD and implant-supported fixed partial dentures, both treatment approaches, cause facial soft tissue changes, which may help to improve the facial esthetic. The effects of these treatment methods on facial soft tissues are not significantly different, except the philtrum height.
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Correlation of Cardiovascular Risk Parameters with Serum IL.6 and C-RP in Myocardial Infarction
RA Ghamri, KW Alghalayini, M Baig
March 2022, 25(3):299-303
DOI
:10.4103/njcp.njcp_1504_21
PMID
:35295052
Aims and Background:
Determine the correlation between cardiovascular risk parameters with serum interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) in acute myocardial infarction (AMI).
Patients and Methods:
Blood samples were obtained from 100 AMI patients (aged 40--60 years) admitted to the intensive care unit of our institution from March 2019 to February 2020, and from 40 age- and BMI-matched healthy adults.
Results:
Median IL-6 and hs-CRP levels were significantly higher in the AMI group (
P
< 0.001), as were fasting plasma glucose, HbA1c, triglycerides, and LDLc, while HDLc was significantly lower. In the AMI group, hs-CRP was significantly correlated with BMI (r = 0.531;
P
< 0.001) and waist circumference (r = 0.448;
P
< 0.001). No significant differences in hs-CRP and IL-6 levels were observed between male and female AMI patients (5.90 ± 2.0 vs. 6.80 ± 8.2,
P
= 0.166; 21.23 ± 8.2 vs. 21.06 ± 8.7,
P
= 0.948, respectively), although IL-6 levels significantly differed between male and female controls (6.64 ± 3.0 vs. 9.74 ± 4.7,
P
= 0.017).
Conclusion:
IL-6 and hsCRP were significantly higher in the AMI group; however, no correlations with the biochemical parameters were observed. Further research into their involvement in the pathogenesis of AMI is needed.
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Atomic force microscopy study on the effect of different irrigation regimens on the surface roughness of human root canal dentin
I Tsenova-Ilieva, S Simeonova, E Karova
March 2022, 25(3):261-266
DOI
:10.4103/njcp.njcp_1379_21
PMID
:35295046
Background:
Endodontic irrigants could alter the mechanical properties of root canal dentin, such as its roughness.
Aim:
To compare the effect of various irrigation protocols on root canal dentin roughness with respect to their application time, concentration, and additional ultrasonic activation.
Materials and Methods:
Forty single-rooted, non-endodontically treated upper incisors were decoronated and further sectioned longitudinally in a buccolingual direction. The surfaces of all eighty samples were polished and randomly segregated to eight equal groups (n = 10): Group A: 2% NaOCl/2 min followed by 17% EDTA/2 min; Group B: 2% NaOCl/5 min followed by 17% EDTA/5 min; Group C: 5.25% NaOCl/2 min followed by 17% EDTA/2 min; Group D: 5.25% NaOCl/5 min followed by 17% EDTA/5 min; Group E: 2% NaOCl solution, ultrasonically activated for 2 min; Group F: 5.25% NaOCl, ultrasonically activated for 2 min; Group G: 2% NaOCl/2 min followed by 17% EDTA/2 min, both ultrasonically activated; Group H: Control group (distilled water).
Results:
All irrigation regimens increased root dentin surface roughness in comparison with the control group. The analysis of the values revealed significant differences between the arithmetical average roughness values (Ra) in the groups (p < 0.001). A statistically significant increase in the Ra parameter was observed in groups E, F, G, and D. The irrigation protocol in Group A showed a significantly smoother dentin surface than those with the ultrasonic activation.
Conclusion:
All tested irrigants increased root canal dentin roughness and the effect was time and concentration-dependent. The ultrasonic activation of the disinfection solutions roughened the root dentin surface significantly.
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What is the relationship of varicose vein pathogenesis with collagen fibers?
S Kocarslan, A Kocarslan, A Doganer, A Yasim
March 2022, 25(3):304-309
DOI
:10.4103/njcp.njcp_1505_21
PMID
:35295053
Aims and Background:
In this study, the densities of collagen 1 and collagen 4, which are an effective vascular component in the remodelling of varicose veins, were investigated.
Materials and Methods:
The study included primary varicose vein samples of 20 patients and vein samples of 20 healthy controls. Immunohistochemical staining was performed using collagen 1 and collagen 4 antibodies. Histochemical staining was performed using Masson Trichrome.
Results:
In the immunohistochemical analysis of varicose samples, collagen 1 immunostaining was negative in 17 cases (85%) and positive in 3 cases (15%). In healthy venous tissue samples, collagen 1 immunostaining was negative in 12 cases (60%) and positive in 8 cases (40%). There was no statistically significant difference between both groups concerning collagen 1 immunostaining (p > 0.05). In varicose samples, collagen 4 immunostaining was negative in 4 cases (20%) and positive in 16 cases (80%). In healthy venous tissue samples, collagen 4 immunostaining was negative in 13 cases (65%) and positive in 7 cases (35%). Statistical comparison of healthy veins and varicose veins concerning collagen 4 immunostaining showed a significant difference (p = 0.03). In the histochemical analysis of varicose samples, Masson Trichrome staining was negative in 4 cases (20%) and positive in 16 cases (80%). In healthy venous tissue samples, Masson Trichrome staining was negative in 18 cases (90%) and positive in 2 cases (10%). Statistical comparison of healthy veins and varicose veins concerning collagen 4 immunostaining showed a significant difference (p = 0.01).
Conclusion:
The change in the density of collagen types plays an important role in vein wall remodeling.
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Effects of C-factor on dentin bonding using various adhesive systems
T Yoshikawa, M Arakawa
March 2022, 25(3):255-260
DOI
:10.4103/njcp.njcp_1364_21
PMID
:35295045
Aims and Background:
This study evaluated the effect of C-factor on the bond strength of a resin composite to floor and wall dentin using various adhesive systems.
Materials and Methods:
Four dentin substrates (flat wall, flat floor, cavity wall, or cavity floor) were prepared on human molars. Each specimen was restored with one of three adhesives; Clearfil SE Bond, Single Bond, or Clearfil tri-S Bond followed by buildup or filling using Z100 resin composite. The specimen was cut perpendicular to the bonded surface parallel to the floor or wall to obtain beams after light curing at 24,000 mJ/cm
2
. The microtensile bond strength to wall specimens or the cavity floor was determined. Data were analyzed.
Results:
All adhesive systems exhibited the highest bond strength to flat wall group (
p
< 0.05). The bond strength to the cavity group was significantly lower than that to the respective flat group regardless of the bonding system (
p
< 0.05). There was no significant difference in bond strength with Clearfil SE Bond and Clearfil tri-S Bond between the cavity wall and cavity floor (
p
> 0.05).
Conclusion:
The findings suggested that the strength of bonding to the cavity floor and cavity wall was affected by C-factor regardless of the adhesive system. Bonding to flat wall was higher than flat floor regardless of the adhesive system. Self-etching system provided uniform bond to the cavity wall and cavity floor dentin. However, total etching system reduced bond to the cavity floor than to the cavity wall.
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Associaton of dermatoglyphic patterns and salivary pH with DMFT index of patients in Riyadh
Amara Swapna Lingam
March 2022, 25(3):294-298
DOI
:10.4103/njcp.njcp_1490_21
PMID
:35295051
Background:
Dental caries is a multifactorial disease with a genetic disposition.
Aim:
To evaluate correlation among dermatoglyphic patterns, salivary pH, and dental caries.
Materials and Methods:
A cross-sectional study was conducted in 150 randomly selected volunteers between 15 and 30 years of age who visited dental clinics from November 2019 to December 2020. Caries status was evaluated as decayed, missing, filled teeth (DMFT) index, and salivary pH was measured. Patients with a DMFT score of 0–5 were into Group A, those with DMFT 5–10 into Group B, and those above 10 were classified into Group C. The dermatoglyphic patterns on the palmar digits of participants were recorded using the method by Cummins and Midlo.
Results:
A higher salivary pH was observed in Group A and Group B when compared with Group C (
P
= 0.001), and this difference was statistically significant. Group A exhibited a statistically significant association with the arch form of fingerprint (58.1%), whereas Group B exhibited a statistically significant association with the loop form (51.9%). Group C exhibited a statistically significant association with the whorl pattern of fingerprint pattern (98.8%) (
P
= 0.001).
Conclusion:
The loop pattern is associated with lesser incidence of caries, whereas whorl pattern is associated with higher incidence of caries. Dermatoglyphics is a noninvasive method that can be used to identify caries susceptibility and take appropriate prophylactic measures.
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Uncorrected refractive error in a university community
CC Anajekwu, N Kizor-Akaraiwe
March 2022, 25(3):361-367
DOI
:10.4103/njcp.njcp_1603_21
PMID
:35295061
Aims and Background:
To determine the prevalence and pattern of uncorrected refractive error among staff of a Nigerian university.
Patient and Methods:
A cross-sectional study of consecutive staff of the University of Nigeria, Nsukka, Nigeria who presented for a 10-day free eye screening program. Demographic data and data on eye care awareness and knowledge were obtained with a combination of self-administered and interviewer-administered questionnaires in the English language. Clinical examinations included visual acuity taken at 6 m with Snellen's chart; noncontact tonometry; pen-torch eye examination; and direct ophthalmoscopy; autorefraction and subjective refraction.
Results:
One thousand and eighty-three subjects aged 18–82 years (mean = 44.1 ± 12.15 years) comprising 568 females (52.4%) and 515 males (47.6%) were screened. Eighty-nine subjects (8.3%) were visually impaired and five subjects (0.5%) were blind. Three hundred and fifty-six subjects were diagnosed with refractive error (356/1083; 32.9%), out of which 149 subjects (41.9%) were uncorrected. The prevalence of uncorrected refractive error in this study population was 13.8%. Astigmatism was the commonest refractive error, whereas hypermetropia and hypermetropic astigmatism were the commonest spherical and astigmatic errors, respectively.
Conclusion:
A significant proportion of the staff of this Nigerian university still lives with uncorrected refractive error with its attendant consequences. Regular eye checks should be done by the staff of our universities and effort should be intensified in eye care awareness creation among the populace, including the apparently enlightened communities.
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The efficacy of different sealer removal protocols on the microtensile bond strength of adhesives to a bioceramic sealer-contaminated dentin
ZG Bek Kurklu, HO Yoldas
March 2022, 25(3):336-341
DOI
:10.4103/njcp.njcp_1575_21
PMID
:35295057
Background:
The optimal bonding of adhesives to dentin requires the sealer to be completely removed from the dentinal walls.
Aim:
This study compared the efficacy of different sealer removal protocols on the microtensile bond strengths (MTBS) of single-step adhesives to a calcium silicate-based bioceramic root canal sealer-contaminated dentin.
Materials and Methods:
Standardized box-shaped Class I cavities were prepared in human lower third molars (
N
= 50). All cavities were contaminated with a bioceramic root canal sealer (Endosequence BC Sealer, Brasseler, Savannah, USA), except the control group (G1) cavities. For the experimental groups, contaminated dentin surfaces were wiped with a dry cotton pellet (G2), wiped with a cotton pellet saturated with water (G3), rinsed with the air/water spray (G4), and passively applied aqueous ultrasonic energy with an ultrasonic scaler (G5) before the restoration procedure. All the cavity surface was restored with a one-bottle universal adhesive and composite resin. All the specimens were subjected to both thermocycling (2,500 thermal cycles from 5 to 55°C, with a 30-s dwelling time and a 10-s transfer time) and mechanical loading (50 N load for 100,000 cycles). The restored specimens were sectioned into resin-dentin beams for MTBS evaluation. Additional specimens were prepared for the scanning electron microscopy (SEM) to examine the dentin-adhesive interface (
n
= 10).
Results:
No significant difference was found between the mean bond strengths of the groups. In SEM examination, no residual sealer was found in any group.
Conclusion:
Calcium silicate-based bioceramic sealer was removed from the dentin surface with all removal protocols when evaluated with MTBS after the thermal and mechanical cycle tests.
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The influence of MTAD and QMix on the accuracy of electronic apex locator in locating simulated perforations
A Dumani, AA Ates, CS Ucan, S Yilmaz, I Unal, O Yoldas
March 2022, 25(3):281-285
DOI
:10.4103/njcp.njcp_1444_21
PMID
:35295049
Aims and Background:
The aim of this study was to evaluate the accuracy of the electronic actual length in detecting artificial perforations of the root canal in the presence of saline solution (NaCl, (Eczacibasi, Istanbul, Turkey), chlorhexidine [CHX (Werax, Tunadent, Izmir, Turkey)], QMix (Dentsply Tulsa, Maillefer, Ballaigues, Switzerland), and MTAD (Dentsply, Tulsa Dental, Tulsa, OK, USA).
Materials and Methods:
The root canals of 25 single-rooted extracted human teeth were perforated artificially in the middle section of the root. The actual lengths up to the perforation site were measured and then, the teeth were embedded in an alginate mold. Electronic measurements of the perforations were obtained by an electronic apex locator according to the manufacturers' recommendations under dry conditions and in the presence of NaCl, CHX, MTAD, and QMix using a #20 K-file. Each canal was irrigated with distilled water and then dried with paper points between the measurements. Statistical analyses were performed using the Friedman test and Spearman Rank correlation coefficient to assess the correlations between the measurement methods.
Results:
Highest correlation between the actual length and the electronic measurement was observed under dry conditions and NaCl solution (r: 0.932, r: 0.940 respectively), and the least correlation was observed with MTAD solution (r: 0.697) using statistical analysis. Moreover, the accuracy of the electronic apex locator with different irrigation solutions was statistically different from each other (
P
= 0.001).
Conclusion:
The most accurate electronic measurements of artificial perforation were obtained under dry conditions or with NaCl.
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Is there a threshold for red cell distribution width to predict malignancy in breast masses?
OM Akturk, D Yildirim, M Cakir, YM Vardar, F Erozgen, M Akinci
March 2022, 25(3):349-353
DOI
:10.4103/njcp.njcp_1583_21
PMID
:35295059
Background:
Red cell distribution width (RDW) has been shown to have predictive properties in different diseases as well as solid cancers.
Aim:
We aimed to investigate the discriminative properties of RDW in benign and malignant breast lesions.
Subjects and Methods:
In a retrospective cohort study the files of patients who underwent surgery for fibroadenomas (Group A) and breast cancer with axillary lymph node metastasis (Group B) were reviewed. The pathology reports and laboratory parameters and demographics of the patients were recorded for comparison. The patients were later excluded if they had an hemoglobin level below 12 mg/dl and the outliers were removed for a comparison. Seventy-six patients in the fibroadenoma group and 62 patients in the breast malignancy group were compared for the RDW levels to predict the presence of malignancy. Receiver operating characteristic curves were plotted for RDW and a threshold for prediction of malignancy was calculated.
Results:
The difference in RDW levels between group A and group B was found to be significant, 13,10% (IQR 12.60 -13.70) versus 13,80% (IQR 13.10-14.40) respectively,
P =
0,00. The area under the curve was 0.71 (95% confidence interval 0.62 to 0.79),
P =
0,00. For the threshold of 13,75 the positive predictive value was 67.35 (95% CI 55.72 to 77.17) and negative predictive value was 67.42 (95% CI 60.76% to 73.44).
Conclusion:
The RDW levels, after adjusted for anemia, were found to have a positive prediction for malignancy in more than two thirds of the patients for the level of 13.75%.
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CASE REPORTS
Bilateral accessory middle turbinate presenting as double middle turbinate: A unique case report
MS Adli, RR Ramli, Baharudin Abdullah
March 2022, 25(3):376-378
DOI
:10.4103/njcp.njcp_1774_21
PMID
:35295064
Many anatomical variations of the middle turbinate (MT), including pneumatized, paradoxically curved, bifurcate, trifurcate, secondary, and accessory, have been described. The most common is pneumatized MT (concha bullosa), but other less common variations may also impact the outcome of clinical management. Anatomical variations of the MT, particularly with a concomitant deviated nasal septum, tend to obstruct the middle meatus leading to disruption of the normal sinus drainage and worsening the symptoms of rhinosinusitis. By recognizing the unique anatomical variant by endoscopy or imaging will help us to improve the management. We report an endoscopic presentation of a rare accessory MT.
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ORIGINAL ARTICLES
Primary minor salivary gland tumors: A retrospective review of cases seen in a tertiary institution in South East Nigeria
JO Akpeh, UC Okechi, BC Ezeanolue
March 2022, 25(3):368-372
DOI
:10.4103/njcp.njcp_1639_21
PMID
:35295062
Background:
Tumors of the minor salivary glands (MSGs) are rare. They constitute a wide range of histologic types despite their low frequency.
Aim:
The aim of this study is to evaluate the clinical and pathological features of 11 different tumors of MSGs presented at the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu and to compare them with similar studies done elsewhere.
Patients and Method:
This is a retrospective study of patients with tumors involving the MSGs seen at the OMFS and ORL clinics, UNTH. Information regarding demographic characteristics, duration at first presentation, types of tumors, site and side affected, and treatment given were recorded in patients' medical records. Data were analyzed using SPSS version 23; qualitative variables were compared using Chi-square test.
Result:
One hundred and thirty three cases of various lesions involving the salivary gland were seen within the study period. Fifty three (39.8%) patients met the inclusion criteria and are reported further. Twenty eight (28) cases occurred in males. The mean age of the patients was 39.8 years STD 16.5, while the mean duration of the swellings at presentation was 45.5 months STD 35.4. Pleomorphic adenoma was the most common of the 29 (54.7%) benign histopathologic type seen. The soft palate was the commonest site affected 37 (69.8%). Local excision with wide margin was adequate in treating majority of the swellings 40 (75.5%), while 1 (1.9%) case of recurrence was seen within the study period.
Conclusion:
Tumors involving the MSGs are uncommon; males are mostly affected in our environment.
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© Nigerian Journal of Clinical Practice | Published by Wolters Kluwer -
Medknow
Online since 10
th
November, 2010