bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of Intralesional Verapamil and Triamcinolone Monotherapy in the Treatment of Keloids in an African Population
Authors: Belie O , Ugburo AO , Mofikoya BO , Omidiji OAT , Belie MF
Published: August 2023

Background:

Keloid is a fibroproliferative disorder of dermal origin, common and severe in the dark-skinned individuals. The patients suffer from pain and pruritus with poor body image.

Aims:

We compared the efficacy and side effects of intra-lesional verapamil and triamcinolone in patients with keloids. As most treatments are cumbersome, recurrence is a major problem despite the many treatment modalities. There is need for effective monotherapy with minimal complications.

Materials and Method:

This is a prospective, randomized study of intralesional injection of verapamil and triamcinolone in keloids conducted in the Burns and Plastic unit of a tertiary hospital. There were two groups; triamcinolone treatment group (TTG) and verapamil treatment group (VTG). A total of 115 patients with keloids <10 cm were diagnosed, 37 (32.2%) were excluded, and 78 were included into the study. There were 40 patients in the TTG and 38 patients in the VTG. Eventually, 70 patients completed the study. Triamcinolone 40 mg and 2.5 mg of verapamil were used for TTG and VTG respectively. The changes in the dimensions of keloids were measured using an electronic caliper. The symptoms were assessed using the visual analog score for pain and the pruritus score was adapted from the 5-D pruritus score.

Results:

Triamcinolone completely resolved pain and pruritus in 6 and 12 weeks, respectively, while there was no complete resolution among VTG patients. However, verapamil injection was comparably effective to triamcinolone for small-size keloids.

Conclusion:

Verapamil as monotherapy is less efficaceous in the resolution of symptoms of keloids but is comparable to triamcinolone in reducing the size of small-sized keloids.
Pedicle Screw Fixation with Percutaneous Vertebroplasty for Traumatic Thoracolumbar Vertebral Compression Fracture
Authors: Sezer Can , Sezer Cenk
Published: August 2023

Objective:

This study aims to evaluate the clinical efficacy of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) for the treatment of the thoracolumbar vertebral compression fracture (VCF) without neurologic deficits.

Materials and Methods:

This was a prospective observational study. Between January 2015 and December 2018, 62 patients who had suffered from traumatic thoracolumbar (VCF) burst fractures without neurologic deficits were included in this study. The patients were divided into two groups as follows: patients who underwent PPSF combined with PVP (PPSF-PVP Group; n = 24) and patients who underwent only PPSF (PPSF Group; n = 38). The patients were (PPSF and PPSF-PVP Group) followed up for more than 9 months. The kyphotic angle, compression ratio, and visual analog scale (VAS) score for back pain were analyzed and compared between the two groups.

Results:

The patients were followed up for an average of 9.1 months. Hospital stay significantly decreased in PPSF-PVP Group (P < 0.001). The median VAS score significantly decreased after the surgery in both the groups (P < 0.005), and mean VAS scores in PPSF-PVP Group were significantly lower than those in PPSF Group. No significant (P > 0.005) changes in local kyphosis and the vertebral body height gains obtained at the end of the follow-up period in PPSF-PVP Group. However, local kyphosis increased significantly (P < 0.005) and the central and anterior vertebral body height decreased significantly (P < 0.005) when compared with the PPSF-PVP Group.

Conclusion:

PPSF combined with PVP procedure is a good choice for the treatment of traumatic thoracolumbar VCF; however, due to the lack of long-term follow-up data, concern still exists regarding the effects of pedicle screw procedure after PVP.
Screening for Depression Among Recent Nigerian Graduates
Authors: Nwajei A , Ibuaku J , Esievoadje S , Olaniyan F , Ezunu E
Published: August 2023

Background:

In recent times, Nigerian media have carried multiple reports of violent and traumatic social vices. These are well-known trigger factors for fear, worries, and anxiety for corp members and their families. Core member's presentations at the NYSC primary care clinic are commonly triggered by change in environmental, biological, and psychosocial factors which invariably affect their social and occupational functioning.

Aims:

The objective of the study was to screen for depression symptoms among young recent Nigerian graduates with the view of further evaluating those positive on screening test with subsequent diagnostic tests.

Methods:

The survey was conducted on 327 participants of the April 2017 batch of graduates during the Delta State National Youth Service Corps (NYSC) Orientation Camp period in Issele-Uku, Delta State, Nigeria. They were requested to complete a self-administered questionnaire comprising of 2 sections (i) Socio-demographic profile and (ii) Patient-Health Questionnaire -9 (PHQ-9) - a Depression screening tool.

Results:

The prevalence of depression symptoms in the study was found to be 57.2%. Family size (P < 0.001) and sibling rank (P < 0.001) were the socio-demographic factors found to be related to depression. Independent predictors of depression were family size and sibling ranking.

Conclusion:

The study found the prevalence of depression symptoms among young adults to be 57.2% which is quite high. Family size and sibling rank were found to be independent risk factors.
The Impact of Body Mass Index on Left Ventricular Mass Index, Right Ventricular Function, and Cardiac Dimension of Children with Sickle Cell Anemia in Enugu City
Authors: Chinawa AT , Chinawa JM , Chukwu BF , Ossai N , Ndu IK , Asinobi IN , Uwaezuoke NA
Published: August 2023

Background:

Body mass index is a major determinant of cardiac annular valvar dimension and left ventricular mass index in children with sickle cell anemia.

Objectives:

The study is aimed at ascertaining the impact of Body Mass Index on Left ventricular mass index, right ventricular function and cardiac dimension of children with sickle cell anemia.

Methods:

A case control study in which echocardiographic measurement of cardiac function and structures were ascertained among children with sickle cell anemia compared with hemoglobin AA genotype.

Results:

There were 51 subjects and 50 controls. The subjects comprised 54.9% males and controls, 52.0% male. There was a strong positive correlation between BMI and most cardiac structure diameters among children with normal hemoglobin genotype (Pearson's correlation coefficient value, P < 0.001) There was also statistically significant positive correlation between BMI and LV mass among the subjects (n = 50, r = 0.5, P < 0.001). There was significant positive correlation between BMI and TAPSE in both subjects and controls as well as between BMI and RVSP among the subjects, but not the controls (p < 0.001). There was no significant difference in the number with left ventricular hypertrophy (LVH) based on their nutritional status (n = 51, χ^2 = 7.03, P = 0.32). The BMI correlated negatively with left ventricular mass index (LVMI) among the subjects, but the correlation was not statistically significant (r = -0.1, P = 0.53)

Conclusion:

There was significant positive correlation between BMI and TAPSE in both subjects and controls as well as between BMI and RVSP among the subjects, but not the controls. Body mass index correlated negatively with left ventricular mass index (LVMI) among the subjects.
Providing Physical Activity Education and Counseling During Pregnancy
Authors: Okafor UB , Goon D T
Published: August 2023

Background:

Midwives have a strategic role to inform, educate, and encourage pregnant women to maintain an active lifestyle during pregnancy.

Aim:

This study explored a cohort of midwives' perspectives on providing prenatal physical activity education and counseling during pregnancy.

Subjects and Methods:

Seventeen midwives participated in semistructured interviews which were audio-recorded and transcribed verbatim. A thematic analysis approach was applied to the transcribed qualitative data.

Results:

Midwives rarely provide physical activity education and counseling to pregnant women, citing lack of knowledge on which physical activity to recommend, and the duration and intensity of the physical activity as reasons. Walking is the only physical activity recommended during antenatal sessions. Barriers to providing physical activity education and counseling include shortage of midwives, busy work responsibilities, nonavailability of exercise equipment, and nonprioritization of antenatal physical activity. The midwives also cited overwhelming work responsibilities resulting in extreme fatigue rendering them hardly able to counsel the women. They advocated for the introduction of exercise classes in antenatal health care and the training of midwives on exercises to improve the uptake of midwives' knowledge regarding prenatal exercise and their engagement with pregnant women during antenatal consultations.

Conclusions:

The midwives lacked knowledge of physical activity during pregnancy and rarely provided such education and counseling. They advocated the need for training and workshops on maternal physical activity. Our findings suggest that physical activity should be integrated into the midwifery/nursing curriculum to empower midwives and other health providers to offer evidence-based physical activity education and counseling to women during antenatal health care as part of the primary health-care service.
IL-13 Gene Polymorphisms (-1112 C/T and -1512 A/C) in Patients with Chronic and Aggressive Periodontitis
Authors: Görgün EP , Toker H , Tas A , Alpan AL , Sari I , Silig Y
Published: August 2023

Background:

IL-13 is the key cytokine in the regulation of inflammatory with an autoimmune disease and has an anti-inflammatory effect.

Aims:

This study aimed to compare IL-13 (-1112 C/T and -1512 A/C) gene polymorphisms in patients with aggressive periodontitis (AgP), chronic periodontitis (CP), and periodontally healthy group (C) and evaluate the effect of nonsurgical periodontal therapy on gingival crevicular fluid (GCF) IL-13 levels in patients.

Materials and Methods:

One hundred thirty patients with AgP, 120 patients with CP, and 70 periodontally healthy subjects were included in this study. Clinical parameters were recorded (plaque and gingival index, probing pocket depth, clinical attachment level), and GCF and blood samples were taken at baseline and 6-week. Nonsurgical periodontal therapy was performed in patients with periodontitis. Gene analyses (IL-13 − 1112C/T (rs1800925) and − 1512 A/C (rs1881457) were performed with real-time polymerase chain reaction (PCR) and cytokine levels were determined by an enzyme-linked immunosorbent assay method.

Results:

AgP and CP patients showed significant improvement in clinical parameters after periodontal therapy (P < 0.05). According to results, genotype distributions and allele frequencies in IL-13 variants − 1112C/T and − 1512 A/C were found similarly in all groups (P > 0.05). In the AgP group, GCF IL-13 cytokine level is statistically significant and increased in 6 weeks; however, in the CP group, there is no statistically significant difference between baseline and 6 week. In the AgP group, baseline GCF IL-13 cytokine level is lower than those of the CP group and C group (P < 0.05).

Conclusion:

Within the limits of this study, IL-13 -1112 and -1512 gene polymorphisms have not been associated with AgP and CP, and GCF IL-13 cytokine level is increased after treatment in the AgP group.
Clinical and Pathological Factors Predictıve of Bladder Cancer Recurrence in Patients with Upper Tract Prımary TCC
Authors: Yoldas M , Türk H , Yoldas TK
Published: August 2023

Objective:

To evaluate predictive clinical and histopathological risk factors for bladder cancer recurrence in patients who underwent nephroureterectomy for primary upper urinary tract transitional cell carcinoma (TCC).

Subjects and Methods:

Data of 111 patients, who were diagnosed with upper urinary tract TCC and underwent nephroureterectomy were reviewed A total of 65 patients were included in the study, after excluding 34 patients. Results: Bladder cancer recurrence developed in 20 (30.7%) of the 65 patients under evaluation. The recurrence-free survival rates in the 1st, 3rd, and 5th years were 78.4%, 70.7% and 69.2%, respectively. Lymphovascular invasion and a positive surgical margin were defined as risk factors for bladder cancer recurrence. In addition, patients with multiple tumors and low stage and grade pathology had a high rate of bladder cancer recurrence, although this was not statistically significant.

Conclusion:

After nephroureterectomy, a careful follow-up is required in terms of bladder tumor recurrence especially in patients with a positive surgical margin, lymphovascular invasion, low-grade tumors, or multifocal tumors.
Pattern of Self-Care Practices among Type 2 Diabetes Patients in Southwest, Nigeria
Authors: Enikuomehin AC , Olamoyegun MA , Ojo OA , Ajani GD , Akinlade TA , Ala OA
Published: August 2023

Background:

Self-care practices in individuals with diabetes are important skills required to effectively prevent, manage, and limit complications associated with diabetes since patients spend considerably less time with health care providers than spend alone to manage their diabetes condition.

Aims:

The aim of the study was to assess self-cate practices and their determinants among patients with type 2 diabetes. Hence, this study aimed at assessing self-care practices and their determinants among patients with type 2 diabetes.

Materials and Methods:

This cross-sectional, descriptive, multi-center study was conducted among 348 type 2 diabetes patients selected from six tertiary hospitals in Southwest Nigeria. Descriptive statistical analysis was employed for categorical and continuous variables and multivariable logistic regression assessed association between determinant factors and adherence to self-monitoring of blood glucose (SMBG).

Results:

Of the study participants, 83.1%, 66.9%, 28.4%, and 27.9% adhered to prescribed medications, physical exercise, had meal plans incorporated into their diabetes management and SMBG, respectively. There was a statistically significant association between male gender, duration of diabetes, and previous episode of hypoglycemia with adherence to SMBG practices while lower educational level and use of insulin were associated with less likelihood of adherence to prescribed medications.

Conclusion:

The degree to which individuals with diabetes adhered to recommended self-care practice components were less than satisfactory especially SMBG, physical activity, and having meal plans.
Clinical Presentation of Inguinal Hernia among Adults in Uyo, Nigeria
Authors: Udo IA
Published: August 2023

Background:

Inguinal hernia is a common pathology seen by the general surgeon in the outpatient clinic. Its spectrum of clinical features on presentation significantly varies from the asymptomatic to the complicated.

Objective:

To identify and audit the common clinical presentation and presence of known risk factors for inguinal hernia among adult patients with inguinal hernias presenting to an outpatient clinic.

Methods:

The study involved adults presenting over 1 year at a surgical clinic with a clinical diagnosis of inguinal hernia. Data on age, sex, family history, abdominal pain, constipation, chronic cough, previous hernia surgery as well as features of bladder outlet obstruction and intra-abdominal mass were recorded into a format. Analysis into a simple percentage, mean, and standard deviation was done with SPSS version 17 (SPSS Inc. Chicago, IL, USA).

Results:

Sixty-five patients were enrolled in the study, comprising 49 males (75.4%) and 16 females (24.6%), M:F = 3:1. The mean age was 45.6 years (SD ± 16.9). The 16–40-year age group had the highest incidence of 29 cases (44.6%) of inguinal hernia. A family history of inguinal hernia (31 cases [47.7%]) and history of previous inguinal hernia surgery (15 cases [23.1%])) was observed. Ten patients with previous surgery presented with a contralateral hernia and 5 with a recurrence. Other factors were chronic constipation 10 cases, smoking 9 cases, chronic cough 8 cases, dysuria 7 cases, enlarged prostate 6 cases, abdominal mass 4 cases, and urethral stricture 1 case.

Conclusion:

Inguinal hernia is common among young and middle-aged adults in our series. Many patients have features suggestive of complications at presentation. Family history and past inguinal hernia surgery were important risk factors.
Methylated Spirit versus Chlorhexidine Gel
Authors: Shwe DD , Afolaranmi TO , Egbodo CO , Musa J , Oguche S , Bode-Thomas F
Published: August 2023

Background:

Omphalitis is an important cause of neonatal sepsis (NNS) and mortality. Quantitative estimates of risk of omphalitis-related neonatal death is about 10%–19%. Topical applications of antiseptics have been shown to reduce this risk burden but has not been well investigated.

Aim:

To demonstrate non-inferiority of methylated spirit to chlorhexidine (CHX) gel for prevention of omphalitis, NNS and mortality at day 28.

Methods:

This was a randomized, non-inferiority trial of methylated spirit versus CHX gel with 161 and 162 mother–baby pairs, respectively, conducted between July 2017 and May 2018. SPSS version 23.0 was used for data analysis to examine for incidence of omphalitis, time-to-cord separation, NNS and mortality. Relative risk and 95% confidence interval were used as point and interval estimates, respectively, with a non-inferiority margin of 10% set for CHX gel while a P values <0.05 was statistically significant.

Results:

The median age of newborns was 18 h; (IQR: 8–24) h with the risk of omphalitis being 2% higher with CHX gel compared to methylated spirit (RR = 1.020; 95% CI; 0.988-1.053; P = 0.053). The median times-to-cord separation were 7.0 days (IQR: 2–17) and 7.0 days (IQR: 2–18) for methylated spirit and CHX gel, respectively (mean difference: [FIGURE DASH]0.2145; 95% CI = [FIGURE DASH]0.9085–0.4759; P = 0.544). There was no difference in the risks of NNS and mortality among those treated with methylated spirit compared to those exposed to CHX gel (RR: 1.0; 95% CI = 0.984–1.017; P = 1.000) and (RR: 1.0; 95% CI = 0.994–1.018; P = 0.986) respectively.

Conclusions:

There is no evidence that 96% methylated spirit is inferior to 4% CHX gel in preventing neonatal omphalitis; hence, it may be considered a safe and effective alternative where CHX gel is unavailable.
Addiction and Rehabilitation Processes According to the Youth with Substance History and Members Of Profession—A phenomenological analysis
Authors: Gök F Akgül , Yavaş Ayhan AG
Published: August 2023

Aims:

The aim of this study was to examine the substance-use history of young people in a rehabilitation center in Berlin with a therapeutic community structure, their thoughts about the rehabilitation process, and the evaluations of the center's employees.

Methods:

The study used interviews with the young people in the rehabilitation process and the professionals working in the institution as well as observation studies over a period of three-months. A total of 23 people participated in the study, including 13 young people in the rehabilitation process with a history of substance use and 10 professionals working at the institution. The researchers used a qualitative research method along with a three-month observation study.

Results:

After the interviews, 4 main themes and 5 sub-themes were identified among the young people with a substance-use history, and 4 main themes and 4 sub-themes were identified for the employees.

Conclusion:

It was determined that a well-structured rehabilitation center has positive psychological, social, cognitive, and behavioral effects on young people with a history of substance use.
Diagnostic Accuracy of Fine Needle Aspiration Cytology for Palpable Breast Lumps in a Nigerian Teaching Hospital
Authors: Ogbuanya AU , Anyanwu SNC , Nwigwe GC , Iyare FE
Published: August 2023

Background:

Breast lump is a very common problem in the surgical units of many hospitals. Considering our unique socio-cultural and economic peculiarities, the ideal initial preoperative diagnostic tool for breast diseases should be cost-effective, simple with minimal physical and psychological trauma.

Aims:

This study aimed to evaluate the diagnostic accuracy of Fine Needle Aspiration Cytology (FNAC) in the management of palpable breast lesions in our center.

Methodsology:

This is a prospective study that lasted for one year. Fine needle aspiration cytology was done after clinical examination of all patients who gave consent. Open surgical biopsy was used as a reference standard.

Results:

One hundred and fifteen patients were enrolled. We found that unsatisfactory smears (C1) were seven (6.1%), benign smears (C2), 57 (49.6%), atypical smears (C3), five (4.3%), suspicious of malignancy smears (C4), six (5.2%) and unequivocally malignant smears (C5), 40 (34.8%). Fine needle aspiration cytology achieved high sensitivity (90.4%), specificity (93.7%), positive predictive value (92.2%), negative predictive value (92.2%) and overall diagnostic accuracy (92.2%) for breast lumps in this study. The false positive and negative rates of 7.8% each are both higher than values recommended by National Health Services Breast Screening Program (NHSBSP) of United Kingdom.

Conclusion:

In view of the high sensitivity, specificity and overall diagnostic accuracy combined with early retrieval of pathologic results on first clinic visit reported in this study, FNAC should become a useful tool in the management of breast lumps in our center.
Complications Following Secondary Voice Prosthesis Insertion and Impact of Previous Irradiation on Their Appearance
Authors: Dragicevic DM , Jovic RM , Kljajic VL , Vlaski LM , Savovic SN , Lemajic-Komazec SN
Published: August 2023

Objective:

The aim of this study was to analyze the complications following secondary voice prosthesis insertion and impact of previous irradiation on their appearance.

Methods:

This study included 106 totally laryngectomized patients who underwent secondary Provox 2 voice prosthesis insertion. Among them, 79 (74.5%) were irradiated. Surgery, prosthesis, fistula, and voice-related complications were analyzed and presented.

Results:

Complications occurred in 23 (22%) patients. Fifteen of them were previously irradiated. There were no surgery-related complications. In the group of prosthesis-related complications, one patient had increased negative pressure during swallowing with extremely short prosthesis life time. There were 17 complications in the group of fistula related ones; 3 patients had excessive granulation tissue around the fistula and 14 patients experienced prosthesis displacement (7 had closed esophageal end of the fistula, 5 had the prosthesis turned sideways in an open fistula, one patient inhaled and one ingested the prosthesis). Tracheoesophageal voice was not established in 5 patients. Previous irradiation had no statistically significant influence on the complication rate (P = 0,251).

Conclusions:

The majority of complications following secondary voice prosthesis insertion are fistula-related ones, among which, displacement of the voice prosthesis is the most common. Previous irradiation does not significantly increase the risk of developing complications.
Rehabilitation of Severe Atrophic Ridges with Zygomatic Implant and/or All-on-4 Treatment Concepts—A Case Series
Authors: Rao Srinivas B , Sangolikar Deepak K , Mishra Sunil K , Chowdhary Ramesh
Published: August 2023

Rehabilitation of completely edentulous patients with implant-supported prosthesis (ISP) is the need of the day, but in many patients, the routine ISP is not possible due to the severe atrophic residual ridges. The present case series describes three cases with atrophic ridges rehabilitated using zygomatic implants and/or All-on-4 treatment concepts. In case 1 and case 3, in maxillary arch, there was not enough bone in Zone 3 to rehabilitate the patient with routine protocol followed for the All-on-4 treatment concept, so in these two cases, zygomatic implants were placed. Case 1 and case 2 were rehabilitated with Malo Bridge and case 3 with acrylic teeth-hybrid prosthesis using a computerized milling procedure to obtain improved fit, function, esthetics, and ease of retrievability whenever required.
Large Solitary Scalp Metastasis of Renal Cell Carcinoma
Authors: Altinkaya A , Yazar S , Karadag EC , Er O
Published: August 2023

Renal cell carcinoma (RCC) can metastasize to various organs of the body. The skin is an uncommon site for metastasis. However, if metastasis to skin occurs, scalp is a common area. We present a 77-year-old male patient, with a 12-year history of RCC. In the current presentation, he was hospitalized due to hematuria, fatigue, electrolyte imbalance, and deteriorating kidney functions. After the patient was stabilized, he was referred to the plastic surgery clinic due to an unusual, extremely large, hemorrhagic, ulcerative, and vegetative mass on his scalp. Total excision of the scalp mass was performed and, it was noted that the calvarium was intact and the defect was grafted. Histology report of the specimen confirmed to metastatic RCC. Clinicians need to keep in mind that large cutaneous lesion can be a metastasis from an internal malignancy.
The Role of Interventional Pulmonology for the Postoperative Bronchopleural Fistula
Authors: Ayten O , Özdemir C , Sökücü SN , Kocatürk C , Önür ST , Altin S , Dalar L
Published: August 2023

Background

Postoperative bronchopleural fistula (BPF) remains a serious complication due to its high morbidity and mortality. Although various endoscopic techniques have been defined for the closure of BPF previously, no standard algorithm yet exists.

Aims:

To study the effectiveness and safety of various endoscopic procedures in an interventional pulmonology unit.

Materials and Methods:

The medical data of 15 postoperative BPF patients, who were undergone endoscopic intervention were retrospectively investigated.

Results:

The mean size of the fistulas determined by bronchoscopic evaluation was 7.93 ± 3.26 mm (range 3-15 mm). Applied procedures were as follows: stent implantation (n: 8, 53.3%), stent implantation and polidocanol application (n: 4, 26.7%), only Argon Plasma Coagulation (APC) application (n: 2,13.3%), polidocanol application (n: 1,6.7%). Complete fistula closure was achieved in three of the 15 patients (20%). The procedures were partly successful in five (33.3%) patients and failed to be successful in seven (46.6%) patients. Survival rates in regard to procedural success were determined and a statistically significant difference was found in five-year survival rates (P = 0.027, P < 0.05).

Conclusion:

Our results demonstrated that bronchoscopic procedures can be safely and effectively performed in patients who were not eligible for surgery for various reasons.
The Role of Contrast Fluoroscopy in Modern Day Oesophageal Imaging
Authors: Baduku TS
Published: August 2023

There has been a slow but steady decline in the frequency of contrast fluoroscopic studies performed all over the world, including oesophagography. This trend is attributed to the increasing availability of endoscopy, computed tomography (CT), and magnetic resonance imaging (MRI). Other diagnostic modalities that are continually supplanting oesophagography are manometry and oesophageal pH monitoring. As a result, contrast oesophageal imaging as a diagnostic modality is gradually being relegated to the background by both the radiologists and other physicians. The aim of this paper is to consider some of the reasons responsible for the general decline, especially as it relates to the third world, and to review, in general terms, the role of contrast oesophageal imaging studies in the diagnoses of gastro-intestinal diseases, and the reasons for continuous use of this modality in modern medical practice.
Urinary Incontinence in Women aged 40 and Older
Authors: Yağmur Y , Gül S
Published: August 2023

Background:

Urinary incontinence (UI) paves the way for many health problems ranging from discomforts of continuous wetness and irritation to social isolation and depression in women.

Aim:

The aim of this study was to determine the prevalence of UI in women aged 40 and older as well as its risk factors and also its effect on quality of life.

Materials and Methods:

This cross-sectional study was conducted with 286 women included in the sample. Subjects were selected randomly. The data were collected using a questionnaire, which was prepared by the researchers, and the Incontinence Quality of Life Questionnaire. The data were analyzed using number, percentage, mean, Chi-square test, and binary logistic regression analysis in the SPSS program.

Results:

It was found that 86 (30.1%) of the women experienced the symptom of UI. The women had mostly the mixed UI. The correlations between UI and age, educational level, status of employment, the presence of chronic diseases, chronic constipation, difficult birth history, and state of menopause were significant. Total mean score of the women with UI for the Incontinence Quality of Life Questionnaire was 73.62 ± 24.36 and the most affected domain of the quality of life field was social embarrassment.

Conclusions:

In the present study, it was found that UI was prevalent in Turkish women and impaired their quality of life. The results can help to provide education and counseling services to women in a society-sensitive manner.
Clinical Comparison of Patients with Angiography
Authors: Arslan A , Acik V , Bilgin E , Afser KA , Cavus G , Gezercan Y , Okten AI
Published: August 2023

Aims:

This study aimed to compare the clinical courses, complications, and clinical outcome scores of patients with perimesencephalic (PM) and nonperimesencephalic (n-PM) subarachnoid hemorrhage (SAH) with no vascular pathology observed on cerebral angiography.

Materials and Methods:

This retrospective study included 52 of 310 patients who underwent cerebral digital subtraction angiography for SAH between October 2016 and April 2018. The patients were categorized into PM and n-PM groups based on the type of hemorrhage observed on brain CT. The patients Fischer's grades, Glasgow Coma Scale scores, and World Federation of Neurosurgical Societies SAH grades were recorded. Hydrocephalus, vasospasm findings in both groups, and modified Rankin scale (mRS) scores were assessed, and vascular pathology factors (diabetes mellitus, hypertension, and smoking) were compared between the patient groups.

Results:

The PM group included 30 patients, the n-PM group 22 patients. Minimal hydrocephalus was observed in two patients in the PM group and six patients developed apparent hydrocephalus in the n-PM group. Angiographic vasospasm was observed in four patients in the n-PM group but none of the patients in the PM group. On discharge, all patients in the PM group had mRS scores of 0. One patient in the n-PM group become exitus and 18 patients were discharged mRS 0, 2 for two patients, and 3 for one patient.

Conclusion:

The patients with PM SAH experienced a benign course, whereas those with n-PM SAH showed a higher risk of vasospasm and hydrocephalus as well as worse exit scores.
The Impact of Restarting the High-Risk Procedures for COVID-19 Infection in Dental Practice on the Anxiety of Dental Employees
Authors: Kirli M Cakir , Kirli U
Published: August 2023

Background:

As SARS-CoV-2 is detected in the infected patients' saliva, dental employees performing aerosol-generating procedures are at high risk of being infected/spreading the infection.

Aims:

This study aimed to assess the impact of restarting the high-risk procedures for COVID-19 infection in dental practice during the pandemic on the anxiety levels of dental employees.

Methods:

All dental employees (dentists, nurses, data entry/cleaning staff) working in a university dental clinic were invited to the study and eighty-one employees (response rate: 97.5%) participated in the study. The volunteers' anxiety was measured consecutively twice with the State-Trait Anxiety Scale: First, on the day prior to restarting the high-risk procedures and the second, on the day these procedures began. Data were analyzed using t tests and the repeated measures ANOVA.

Results:

The state anxiety level of the dental employees increased significantly on the day that the high risk procedures were restarted (mean 42.6 vs. 49.0, d = 0.6, P < 0.001). Concerning the subgroups, the increase in state anxiety levels was significant for females (t = 3,7; d = 0,8; P < 0.001), dentists working in departments of endodontics and restorative dental care (t = 3,5; d = 0,9; P < 0.001) and nurses (t = 2,8; d = 0,9; P < 0.001). The analysis showed no significant difference in trait anxiety levels between the assessment days (mean 44.0 vs. 44.2, P = 0.9).

Conclusions:

Restarting the high-risk procedures for COVID-19 infection in dental practice during the pandemic seems to be an extra stressor for dental employees' who already have high anxiety levels during the pandemic.
Effects of Amoxicillin on Gingival Biopsies and Oral Smears
Authors: Alkan B , Koroglu P
Published: August 2023

Background:

Antibiotic use in research volunteers partaking in dental studies varies widely, as inclusion and exclusion criteria used in participant selection lack strict rules.

Aim:

We aimed to investigate the most appropriate ending time of amoxicillin therapy in healthy subjects before their recruitment and participation in oral histology trials. A cross-sectional design study was conducted in Istanbul, Turkey, between October 2018 and June 2019.

Subjects and Methods:

Study participants who had undergone a previous course of amoxicillin were divided into three groups according to the amount of time since their last antibiotic dose: group I, within 1 month; group II, within 4–6 months; and group III, within 7–12 months. Periodontal parameters were measured, and smear samples were obtained from buccal mucosa and keratinized gingiva. Gingival biopsies were taken from the upper premolars. Genetic damage and histopathological damage were analyzed with Feulgen reaction and with hematoxylin–eosin staining. Data were analyzed using the Mann–Whitney U, Kruskal–Wallis, and the Pearson Chi-square tests.

Results:

There were no significant differences in the periodontal parameters and sociodemographic characteristics between the groups (P > 0.05). Higher genetic and histopathological damage scores were observed in group I, which were significantly different compared to the other groups (P < 0.05). No significant differences were observed between groups II and III (P > 0.05).

Conclusions:

When selecting healthy participants for oral histology trials, at least 3 months should pass after the final dose of amoxicillin is taken to avoid negative effects on gingival tissue and smear samples.
Biomechanical Properties and Biocompatibility of Implant-Supported Full Arch Fixed Prosthesis Substructural Materials
Authors: Eraslan R , Colpak ED , Kilic K , Polat ZA
Published: August 2023

Objectives:

The purpose of this study was to investigate the fracture resistance, biocompatibility, hardness, and transverse strength of non-precious metal alloy (chromium-cobalt; Cr-Co), titanium (Ti), zirconia (Zr), polymethylmethacrylate (PMMA), and polyetheretherketone (PEEK) when employed as substructure materials according to the implant supported full arch fixed prosthesis treatment concept.

Materials and Methods:

In total, 150 Cr-Co, Ti, Zr, PMMA, and PEEK samples (n = 30 per material) measuring 25 × 2 × 2 mm in size were produced. Of the samples, 50 (n = 10 for each material, all having dimensions of 6 × 3 mm) were subjected to biocompatibility tests. The Vickers hardness test and three-point bending test were performed; fracture resistance measurements were taken and the biocompatibility of the samples was evaluated by the XTT assay.

Results:

Vickers hardness was highest for Zr (p < 0.05). PEEK and PMMA had the lowest (and similar) fracture resistance values (p < 0.05). Cell proliferation on the surfaces of the materials was similar between PEEK and Zr (p > 0.05), which were the most biocompatible materials.

Conclusions:

Within the limitations of this study, the most favorable materials in terms of biocompatibility were found as PEEK and Zr. When biomechanical properties are evaluated, the most durable materials can be specified as Cr-Co and Zr. Also, further studies are needed to improve material stability.
Impact of COVID-19 on Ophthalmic Outpatient Services in An Eye Care Center in Southern Nigeria
Authors: Osaguona VB , Osahon AI , Uhumwangho OM
Published: August 2023

Background:

Coronavirus disease-2019 (COVID-19) is a communicable disease and a global pandemic affecting different parts of the world including Nigeria. Measures to curb the spread of the causative virus included a nationwide lockdown.

Aim:

The aim of this study was to assess the impact of COVID-19 on ophthalmic outpatient services in an eye care center in Nigeria.

Method:

The medical statistics for all persons attending the Ophthalmic Outpatient Clinic from January to August 2020 and January to August 2019 was obtained. The statistics for January to August 2020 was compared with that of the corresponding months in 2019 for outpatient clinic attendance, gender, and number of children and adults.

Results:

In the 2019 study period, the total number of patients attending the Ophthalmic Outpatient Clinic was 16,189. There were 6788 males, 9401 females, 2963 children, and 13,226 adults. In similar months in 2020, the total number of patients was 8,735, of which 3,934 were males, 4801 females, 1651 children, and 7084 adults. There was an overall decline of 46% in the number of outpatient attendance in 2020. The decline was 76.3% in April 2020 (peak of the lockdown). There was a rebound in outpatient visits in July 2020 (when the interstate travel ban was lifted) to 4.9 times that of April 2020; however, this was 56.9% that of July of the preceding year.

Conclusion:

COVID-19 pandemic impacted negatively on outpatient visits. A rebound in the number of visits was observed when the interstate travel ban was lifted, although far below the preceding year's value.
Myxoma Complicated Acute Intestinal Obstruction
Authors: Ersoy O , Sekmen U , Balmuk AB , Girit A
Published: August 2023

Myxomas are slowly growing mesenchymal tumors and are considered as extremely rare benign tumors of small intestine. This is the case of a young woman presenting with acute bowel obstruction due to ileo-ileal intussusception caused by an intraluminal 4- cm solitary nodule, found to be a myxoma upon pathologic examination, after resection by surgery.
Polypoidal Choroidal Vasculopathy Amongst Nigerians; A Multicenter Study
Authors: Adenuga O , Okonkwo ON , Udoh MM , Ovienra W , Ibanga A , Agweye C , Nkanga D , Akanbi T , Oyekunle I
Published: August 2023

Objective:

To investigate the prevalence and presentation of polypoidal choroidal vasculopathy (PCV) in Nigerians.

Methods:

A cross-sectional, multicenter, hospital-based, descriptive study. Data were collected prospectively between January and December 2018, from consecutive patients diagnosed to have a retina disease at the general outpatient and retinal clinics of four eye departments in Nigeria. All participants had visual acuity, refraction, intraocular pressure, anterior segment examination, and dilated fundus examination. Some patients had fundus fluorescein angiography, optical coherence tomography (OCT), and OCT angiography (OCTA). Systemic comorbidity was determined by medical history and systemic evaluation. Diagnosis of PCV was based on clinical findings, and in some patients using OCT.

Results:

A total of 8,614 patients were seen and 15 patients (18 eyes) were diagnosed to have PCV giving a yearly hospital-based prevalence of 0.17%. The mean age at presentation was 63.27 ± 11.5 years (range 44–84 years). There were nine females (60%). The male: female ratio was 1.5:1. Twelve (66.7%) of the 18 eyes were blind, 16.7% had severe visual impairment while 11.1% had mild visual impairment. Seven eyes (38.9%) had vitreous hemorrhage. Of the 12 blind eyes, 50% had vitreous hemorrhage (P= 0.463). Nine patients (60%) had systemic hypertensive as comorbidity (P= 0.016).

Conclusion:

PCV is a cause of vision loss among Nigerians. Majority of the eyes were blind and 50% of blind eyes had vitreous hemorrhage. Since Indocyanine Green Angiography is the most appropriate imaging technology and is mostly unavailable in Nigeria, efforts should be made to address this need and improve the diagnostic accuracy.
Prevalence and risk factors for helicobacter pylori infection among children in Owerri, Nigeria
Authors: Emerenini FC , Nwolisa EC , Iregbu FU , Eke CB , Ikefuna AN
Published: August 2023

Background:

Helicobacter pylori (H. pylori) is a gram-negative ubiquitous bacterium affecting over half of the world's population. Most infections are acquired in early childhood with highest prevalence in Africa and Asia. Infected individuals develop antibodies against H. pylori which persist up to 6 months after eradication. Low socioeconomic status, poor sanitation, poor personal hygiene, and absence of potable household water supply are prevalent in our environment and also linked with increased frequency of the disease with attendant health consequences.

Aims:

The aim of the study was to determine the seroprevalence of H. pylori infection and potential sociodemographic factors among children in Owerri.

Methods:

One hundred and twenty children aged 6 months to 15 years were studied from March to June 2016. Sociodemographic data was documented in a pretested structured questionnaire while rapid test kit that detects antibody to H. pylori by chromatographic flow was used to identify subjects with infection. Data were analyzed using SPSS version 20.0 with level of statistical significance at P < 0.05.

Results:

H. pylori infection prevalence was 20.0%, increased with age and highest in the 10–15 years age group (P = 0.001). Increasing age and low socioeconomic class (SEC) were found to be significant risk factors of H. pylori seropositivity among study subjects.

Conclusion:

Prevalence of H. pylori infection was high, increased with age and lower SEC as well as highest among children aged 10 years and older. Efforts should be made to exclude H. pylori infection in children with suspected symptoms considering the high burden of the disease in our setting.
Anti-Microbial Efficacy of Root Canal Preparation in Deciduous Teeth With Manual and Rotary Files
Authors: Lakshmanan L , Jeevanandan G , Vishwanathaiah S , Maganur Prabhadevi C , Alzahrani KJ , Alkahtani A , Boreak N , Testarelli L , Baeshen HA , Patil S
Published: August 2023

Background:

In a pulpectomy, the eradication of microbes from the primary root canal is accomplished through biomechanical preparation, which could be carried out with either manual or rotary instruments.

Aims:

The objective of this clinical trial was to evaluate the efficiency of manual K-files, H-files, and Kedo-S Square rotary files in reducing microbial flora after canal preparation in primary molars.

Materials and Methods:

This randomized clinical trial consisted of 45 primary molars requiring pulpectomy. The teeth were randomly allocated to one of the three groups: Group I: Manual K-files, Group II: Manual H-files, and Group III: Kedo-S Square rotary files, based on the type of instrumentation. Pre-and Post-instrumentation sampling was performed using clean absorbent paper points and kept in a clean Eppendorf tube having thioglycolate broth as the transport medium. Culturing was performed on agar media from which both aerobic and anaerobic microbial counts were estimated. Collected data were statistically analyzed using one-way analysis of variance (ANOVA) and Wilcoxon signed-rank test. Following root canal preparation, 87–89% reduction of the aerobic and anaerobic microbial load was noted in group I, whereas it was an 89–92% reduction in group II and a 93–95% reduction in group III.

Results:

Biomechanical preparation with Kedo-S Square rotary file showed higher efficacy in microbial reduction compared to manual instrumentation.

Conclusion:

Manual and rotary files were equally effective in removing root canal microbes. Biomechanical preparation with a KedoS Square rotary file resulted in greater microbial efficacy. Hence In children, effective root canal cleaning in a short period of time is a major consideration.
Transperineal Anastomotic Urethroplasty for Pelvic Fracture Urethral Distraction Defects
Authors: Akpayak IC , Samaila SI , Jacob JB
Published: August 2023

Background:

Currently, transperineal anastomotic urethroplasty approach is the reference standard in the surgical reconstruction of pelvic fracture urethral distraction defects. The approach is suitable for all but the most complex cases which might require abdominoperineal approach.

Aims:

We reviewed our recent experience with transperineal anastomotic urethroplasty with respect to success rate and complications.

Patients and Methods:

This was a retrospective descriptive study carried out at Jos University Teaching Hospital from March 2015 to March 2018. The case notes of male patients who had transperineal anastomotic urethroplasty for pelvic fracture urethral distraction defects within the study period were retrieved. Patients' demographics, cause and nature of pelvic fracture urethral distraction defects, the success rate, and complications were collected and subjected to statistical analysis using SPSS® version 22.

Results:

Sixteen men with mean age of 29.6 ± 7.8 years had transperineal anastomotic urethroplasty for pelvic fracture urethral distraction defect (PFUDD) during the study period. The mean defect gap length was 4.5 cm (range, 2–7 cm). Out of the 16 patients, 6 (37.5%) had simple transperineal urethroplasty, while 10 (62.5%) underwent a more extensive transperineal urethroplasty. Four patients (25%) had inferior pubectomy. A total of 7 (43.8%) patients had erectile dysfunction (ED) before and after the urethroplasty. Five (31.3%) patients had ED before the urethroplasty 2 (12.5%) patients developed ED after the surgery. After mean follow-up duration of 2 years (range, 1–4 years), 12 (75%) patients had satisfactory urinary stream. The mean Qmax for the 16 patients was 16 ml/s (range, 0–35 ml/s). The 12 (75%) patients that had no complaints of LUTS, had Qmax ≥ 15 ml/s at mean follow-up duration of 2 years.

Conclusion:

Transperineal anastomotic urethroplasty for PFUDD is considered suitable technique for treatment of PFUDD with good surgical outcome.