Open Access Case Study

Full Mouth Rehabilitation in a Patient with Amelogenesis Imperfecta: Treatment for Aesthetic and Functional Improvement

Adam Husein, K. M. Abdullah Al Harun, Liyana Ghazali, Mohammad Khursheed Alam

Journal of Advances in Medicine and Medical Research, Page 806-810
DOI: 10.9734/BJMMR/2015/18072

Introduction: Amelogenesis imperfecta (AI) is a dental anomaly that causes defects in enamel with no evident association of systemic disease.
Presentation of Case: This clinical report describes the oral rehabilitation of a 24-year-old woman diagnosed as having hypoplastic type of amelogenesis imperfecta along with palatally positioned maxillary lateral incisors. The aim of the treatment was to eradicate dental sensitivity, to correct of maxillary anterior malocclusion, and to restore esthetics and masticatory function. The treatment included removal of maxillary lateral incisors and placement of metal-ceramic fixed bridge dentures, as well as placement of all ceramic, metal-ceramic and full metal crowns for other affected teeth.
Discussion: Interdisciplinary approach of the management of AI is necessary. Depending on the type and severity of the disorder, esthetic and functional concerns, prosthetic management of anterior teeth, like complete crowns, porcelain laminate veneers are the best options. For many years the most predictable and durable esthetic restoration of anterior teeth has been complete crowns.
Conclusion: Porcelain bonded to metal fixed bridge partial dentures and full ceramic, porcelain bonded to metal and full metal crowns to correct the malocclusion and aesthetic problem, to eradicate sensitivity and to restore the masticatory function in this case was satisfactory.

Open Access Case Study

Nuss Procedure and Factor VII Deficiency: A Case Report

Nesimi Günal, Ayse Anil Karabulut, Meryem Albayrak, Koray Dural, Berkant Özpolat

Journal of Advances in Medicine and Medical Research, Page 811-815
DOI: 10.9734/BJMMR/2015/17627

A 19 year-old boy admitted with pain and discoloration on his chest wall 18 months after a Nuss procedure performed for pectus excavatum deformity. His physical examination revealed that this skin lesion was an ecchymosis. We diagnosed a very rare bleeding disorder due to Factor VII deficiency which is a recessively inherited coagulation disorder where even spontaneous bleedings may be seen. We aimed to discuss the management of the patient, if it had been diagnosed preoperatively and the preoperative preparation before the bar removal.

Open Access Short Research Article

Retrograde Screw Fixation Results of Coronoid Fractures in Terrible Triad

Çetin Isik, Mesut Tahta, M. Atıf Erol Aksekili, Ahmet Firat, Osman Tecimel, Safa Gursoy, Ali Åžahin, Murat Bozkurt

Journal of Advances in Medicine and Medical Research, Page 802-805
DOI: 10.9734/BJMMR/2015/18086

In this study, we aimed to evaluate the results of coronoid fracture fixation, in terrible triad of elbow injury with retrograde screws. Patients between 2008 and 2012 were reviewed. Six were men and 2 were women. Mean age was 44.5(21-62). Mean follow-up period was 25.25 months (8-50). According to Regan and Morrey classification, 6 of the fractures were Type 3 and 2 were Type 2. All cases were operated with single lateral incision. For coronoid fracture, reduction was maintained from anterior aspect and fixed with posterior percutaneous screws which were single 4.5 mm screw in 3 patients and double 3.5 mm screws in 5 patients. Mini and micro cannulated screws for 4 patients and anatomic radial head plates for 4 patients were used for radial head fractures. All lateral ligament complex repairs were performed with bone tunnel technique. The results of the treatment were evaluated with Mayo elbow performance scoring system. All the fractures were united and mean union time was 4 months (3-6). Mean active elbow flexion –extension range of motion at last visit was 108.2º (70º-130º). Mean Mayo elbow performance score of the patients was 87.5 (70-100). With retrograde screw fixation of coronoid fractures in terrible triad, we achieved a stable fixation.

Open Access Original Research Article

Musculoskeletal Disorders in Male and Female Patients and Related Factors

Salma B. Galal, Mahasen Ibrahim, Zeinab El-Sayed Hammour, Reda el-Belbasy

Journal of Advances in Medicine and Medical Research, Page 748-757
DOI: 10.9734/BJMMR/2015/18049

Aim: The aim of the study is to find differences and factors associated to musculoskeletal disorders in male and female patients in primary health care units in Egypt.
Subjects and Methods: This is an exploratory cross-sectional study of a sample of 396 patients with musculoskeletal disorders- 44.7% men and 55.3% women - in primary health care settings in a rural and urban area. Aside from demographic characteristics, the questionnaires included the modified Nordic Musculoskeletal disorders (MSDs) items, duration of disease, family history, physical activities, effect of MSD on life, other diseases and an abbreviated depression score.
Male and female patients were compared in the analysis. Chi-square, t-test, ANOVA were used as significance tests.
Results: The primary MSD for men (36%) and women (40%) is back pain. The age of female patients with back pain was 8.4 years younger (p=0.001) than that of male patients. Women with neck pain were 15.9 years (p=0.001) younger than the men and those with a rheumatic disorder, 18.8 years (p=0.02). Factors related to MSDs in men are accidents, strenuous work and smoking; while factors for women are hormonal medication, family history of MSDs and less physical activities. There was no difference between men and women as regards the depression scores for each MSD.
Conclusion: Female patients suffer from musculoskeletal diseases at a significantly younger age than male patients. Both genders have different risk factors associated with MSDs. Depression scores for MSDs are low.

Open Access Original Research Article

Effect of Different Exposure Conditions and Developing Solution Concentration on the Clarity of Cervical Burnout in Bitewing Radiographs

Mehrdad Abdinian, Fahimeh Hojjati, Shima Golmohammadi, Sajad Ghorbanizadeh

Journal of Advances in Medicine and Medical Research, Page 758-764
DOI: 10.9734/BJMMR/2015/13217

Aims: Exposure and developing conditions can affect the occurrence of cervical burnout in bitewing radiographs which is one of the common false positive errors in these images. This study was designed to evaluate the effect of kilo voltage peak (KVP), milliampere second (mAS) and concentration of developing solution on clarity of cervical burnout in bitewing radiographs.
Study Design: It was an experimental study performed on phantom head.
Place and Duration of Study: Department of Oral and Maxillofacial Radiology, Isfahan University of Medical Sciences in Isfahan, between August 2012 and June 2013.
Methodology: Seven bitewing radiographs were taken by XCP film holder from phantom premolars with different exposure conditions and same intensity. Then films were processed using processing solution with optimum concentration. Radiographic procedures were repeated twice under the same exposure conditions. In the first case, the films were processed by half of optimum concentration of developing solution. In the second case, the films were processed by the condition twice as concentrated as the optimum developing solution. Two oral and maxillofacial radiologists evaluated the clarity of cervical burnout. Data were analyzed using Kruskal-Wallis, Mann–Whitney U and Spearman’s correlation test by SPSS software (Version 11.5).
Results: This study revealed a significant effect of exposure conditions on clarity of cervical burnout (p<0.05) but there wasn’t any significant difference among tested concentrations of developing solution. Moreover, exposure conditions and cervical burnout clarity were significantly correlated. (p<0.05).
Conclusion: The use of lower contrast radiographs (high KVP and low mAs) can be useful for detecting proximal caries and preventing false positive errors like cervical burnout.

Open Access Original Research Article

The Effects of a Delay Following Warm-up on the Heart Rate Response to Sudden Strenuous Exercise

Iris A. Lesser, Alastair N. H. Hodges

Journal of Advances in Medicine and Medical Research, Page 765-771
DOI: 10.9734/BJMMR/2015/17374

Introduction: Sudden strenuous exercise (SSE) has previously been shown to result in electrocardiograph (ECG) abnormalities indicative of myocardial ischemia when not preceded by a warm-up. Athletes regularly undergo SSE and are often unable to warm-up immediately prior to competition. It is unknown whether a delay post warm-up will result in the same heart rate (HR) response to SSE as seen with no warm-up.
Aims: To compare the HR response and to observe for ECG abnormalities during SSE with a warm up, with a delay after warm up and without a warm up.
Methods: Seven male subjects randomly completed three SSE exercise conditions while being monitored by ECG; a 15 second supramaximal sprint following three conditions: no warm up (NW); immediately following a warm-up (WU); and following a 10-minute delay post warm up (D). There were no ECG abnormalities across any of the conditions indicative of myocardial ischemia.
Results: Significant differences (p<0.05) were found in the HR response for all time periods during exercise between WU and NW, between WU and D, but not between D and NW. A delay between warm-up and SSE resulted in a lowered HR response to the SSE compared with a warm-up immediately preceding, but a higher HR response to SSE with no warm-up.
Conclusion: The findings of this study suggest that a 10 minute delay following warm-up before SSE is too long to maintain the benefits of warm-up.

Open Access Original Research Article

Utility of GenoType MTBDRPlus Assay for Direct Detection and Drug Susceptibility Testing of Mycobacterium tuberculosis from Probable Tuberculous Meningitis Patients

Gupta Renu, Thakur Rajeev, Jalan Nupur, Rawat Pumanshi, Kushwaha Suman, Paul Mousumi

Journal of Advances in Medicine and Medical Research, Page 772-780
DOI: 10.9734/BJMMR/2015/18176

Aims: To evaluate GenoType® MTBDRplus line probe assay as a diagnostic tool for detection of Mycobacterium tuberculosis and drug susceptibility testing from cerebrospinal fluid of probable tuberculous meningitis patients.
Study Design: A prospective, double blind study.
Place and Duration of study: Dept. of Microbiology and Neurology, Institute of Human Behavior and Allied sciences, Delhi, India between February 2014 to October 2014.
Methodology: Cerebrospinal fluid collected from 107 probable meningitis patients with diagnostic score >10 were subjected to smear microscopy, automated liquid culture (BACTEC MGIT 960) and Polymerase chain reaction (IS6110). All the samples were also subjected to GenoType® MTBDRplus line probe assay for detecting M. tuberculosis and drug susceptibility. Drug susceptibility testing of all the M. tuberculosis isolates was done by BACTEC MGIT 960 and GenoType® MTBDRplus line probe assay.
Results: The sensitivity, specificity of the assay for M. tuberculosis detection was 49.5%, 100% against clinical diagnosis as reference standard and 68.9%, 100% against definitive diagnosis as reference standard. A diagnostic accuracy of 56.8% (kappa 0.22), 75% (kappa 0.46), were seen in patients with probable and confirmed diagnosis respectively. The drug susceptibility results for Isoniazid and Rifampicin could be delineated in only 39.2% of patients.
Conclusion: This assay proved to have better sensitivity, diagnostic accuracy than smear microscopy and automated liquid culture for early detection of M. tuberculosis from probable tuberculous meningitis patients and has comparable sensitivity to culture (39.2%) for detection of drug susceptibility (though on different isolates). Rapid turnaround time and user friendliness makes it an acceptable assay for simultaneous early detection of M. tuberculosis and its drug susceptibility for better patient management.

Open Access Original Research Article

Potential Neuroprotective Role of Verapamil in Experimentally- Induced Chronic Sciatic Nerve Constriction in Mice

Inas El Sayed Darwish, Iman Samy Dessouky

Journal of Advances in Medicine and Medical Research, Page 781-789
DOI: 10.9734/BJMMR/2015/17908

Objectives: The aim of the current study was to evaluate of three dose levels of verapamil; as a calcium channel blocker that could confer an anti-inflammatory efficacy, in an experimental model of neuropathy in mice that had been subjected to chronic partial constriction of the sciatic nerve.
Materials and Methods: Six groups; each of 10 mice as follows: Oral saline treated control (group I), sham operated (group II), groups subjected to partial constriction of left sciatic nerve (groups III-VI); oral saline control group, groups treated with oral verapamil 15, 30 and 60 mg/kg respectively. Time course behavioral tests were observed namely noxious thermal and non noxious response as well as cold allodynia response at 0, 1,7,14 and 21 day of study. Serum visfatin and serum leptin levels, nerve reduced glutathione, spinal cord brain derived neurotrophic factor as end point biochemical measurements were assessed. All were done after three weeks of oral treatment.
Results: The study revealed significant antinociceptive effect of verapamil (P<0.001) with replenishment of reduced glutathione (P<0.01), significant increase in spinal cord levels of brain derived neurotrophic factor (P<0.001) and reduction of mean serum visfatin levels. No significant effect on mean serum leptin in any treated groups was observed.
Conclusions: Verapamil 60 mg, 30 mg/kg oral dose had the highest significant antinociceptive, regenerative and as well as ability to reduce serum visfatin level after three week therapy.

Open Access Original Research Article

Predictors of Sexual Abstinence and Attitude towards PLHIV among Undergraduate Students in a Privately Owned University in South West Nigeria

Olumide Abiodun, John Sotunsa, Franklin Ani, Ebunoluwa Jaiyesimi

Journal of Advances in Medicine and Medical Research, Page 790-801
DOI: 10.9734/BJMMR/2015/18421

Background: Universities in the high prevalence nations of sub-Saharan Africa have significant proportions of their students and staff being infected with HIV. The prevalence of risk behaviors for HIV/AIDS continues to rise especially among university students. The objective of this study is to identify predictors of sexual abstinence and attitude towards PLHIV among Babcock University students.
Methods: A cross-sectional study of 1225 undergraduates selected by multistage sampling technique was conducted in a privately University in Nigeria. Data were collected using structured self-administered questionnaire.
Results: All the participants were aware of HIV/AIDS. About one-quarter (24.1%) of the students had ever had sex. Knowledge about HIV/AIDS was very high as 87.7% of them had very good knowledge. Between 74.1% and 89.8% of the students demonstrated correct attitude towards the various attitude questions about PLHIV. Students who were less than 21 years (AOR=1.64), do not take alcohol (AOR=1.94), those with good knowledge of HIV/AIDS (AOR=2.15) were more likely to abstain from sex than their counterparts respectively. Male participants (AOR=0.64) were less likely to abstain from sex than females. The likelihood of having poor attitude towards PLHIV was less in those with good knowledge (AOR=0.16) and more in those with self-reported poor knowledge (AOR=2.97) than their respective counterparts.
Conclusions: This study has identified the factors that promote sexual abstinence and reduce HIV-related stigmatization among young people. Many factors are involved. Hence, an integrated multi-sectoral and multidirectional approach is recommended for the provision of relevant HIV/AIDS knowledge, comprehensive abstinence sexuality education to young persons.

Open Access Review Article

Symptomatic Papillary Fibroelastoma- Case Report and Literature Review

Saurabh Joshi, Aditi Ahlawat, Alireza Hosseinnezhad, Mark Kranis, Joshua Greenberg, Robert M. Bojar

Journal of Advances in Medicine and Medical Research, Page 741-747
DOI: 10.9734/BJMMR/2015/17608

Primary cardiac tumors represent a small subset of cardiac neoplasms. The papillary fibroelastoma (PFE) is a benign tumor that typically affects the cardiac valvular system and is second in prevalence only to myxomas. Though typically asymptomatic and diagnosed incidentally, few patients with PFE may also experience neurologic and cardiac symptoms that prompt further diagnostic investigation. We present a case of a patient with transient monocular vision loss with a later occurrence of bilateral lower extremity weakness and confusion over a short period of time. The alarming symptomatology eventually led to diagnosis by transesophageal echocardiogram of a PFE involving the aortic valve. We include a review of the current literature on PFE to further elucidate etiology of this neoplasm, symptomology, prognosis, and treatment. Currently, the role of anticoagulation in PFE remains unclear. Due to the embolic nature of this neoplasm as evidenced by the case presentation, surgical resection, anticoagulation or a combination of both provides patients with maximal prevention of stroke.