Open Access Systematic Review Article

Patients' Satisfaction after Orthognathic Surgery: A Systematic Review

Sepideh Soheilifar, Sara Soheilifar, Mohsen Bidgoli, Elham Sadat Emadian Razavi, Sanaz Soheilifar

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2015/17646

Objective: The aim of the present study is to review data regarding patients' satisfaction after orthognatic surgery in a systematic approach.
Methods and Materials: Electronic searching was done in Medline, EMBASE and CENTRAL databases. Inclusion criteria were: 1) assessment of patients' satisfaction or quality of life, 2) one-stage orthognathic surgery, 3) follow up period of 8 weeks or more, and English, German, Persian and Arabic articles. Exclusion criteria were: 1) presence of craniofacial syndromes, cleft lip and palate or traumatic injuries, 2) previous facial surgery, 3) psychological problems before surgery. Data were extracted and analyzed in three groups: function, appearance and overall satisfaction.
Results: 18 studies met the inclusion criteria. Esthetic and function was improved in majority of patients, however, it was not possible to assess the issue statistically. Overall satisfaction analysis revealed that 88.6% of patients were satisfied, while 2.8% and 8.6% of patients were neutral and dissatisfied, respectively.
Conclusion: Most of the patients were satisfied with the surgical outcome. Satisfaction was seemed to be multifactorial and it was not possible to predict satisfaction prior to the surgery.

Open Access Case Study

Amniotic Membrane Transplantation: A Good Treatment Option for Refractory Neurotrophic Keratitis

Mahmut Kaya, Zeynep Ozbek

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2015/17169

Neurotrophic keratitis is a degenerative disease of the corneal epithelium resulting from impaired corneal innervation, possibly leading to perforation. In this report, we present a case with a history of herpetic keratitis, who developed a difficult neurotrophic ulcer despite 10 days of topical lubricant therapy and oral doxycycline. Amniotic membrane transplantation can be considered an effective alternative for treating persistent and progressive neurotrophic corneal ulcers.

Open Access Case Study

Cushing’s Disease and High Dose Cabergoline Monotherapy: Rapid and Sustained Clinical and Biochemical Improvement, with Reversal of Diabetes, Hypertension and Infertility

Omayma Elshafie, Nagi Hashim, N. Nicholas Woodhouse

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2015/18691

Aims: To assess the effects of high dose long term cabergoline monotherapy in a patient with Cushing's disease refusing any form of surgical intervention.
Presentation of the Case: A 32-year-old Omani female with hypertension, diabetes mellitus and secondary infertility of 10 years and amenorrhoea of 2 years duration, was referred with recurrent thigh abscesses. She was on 100 units of mixed insulin in two divided doses, metformin 1 gm bd, lisinopril 20 mg od, amlodipine 10 mg od and indapamide 1.5 mg od ."She had all the features of Cushing’s syndrome, with a blood pressure (BP) of 180/110 mmHg, plethoric facies, central obesity and striae".
Investigations revealed diabetes, HBA1c 10.7% and ACTH-dependant Cushing’s syndrome, "cortisol 720 nmol/L (normal <624) and ACTH 14.9 pmol/L. (normal 1.6-13.8)". The pituitary MRI and computerised tomographic ( CT) scans from neck to pelvis “ were normal”
A neuroendocrine tumour (NET) was deemed unlikely as serum cortisol levels did not “suppress during by a 72 hours trial” of octreotide 100 mcg 8 hourly and her serum chromogranin- A level (CgA) was normal. A diagnosis of Cushing’s disease was made. She refused inferior petrosal sinus sampling (IPSS) and any form of surgery.
A trial of cabergoline was agreed upon. Her response was dramatic: On 1 mg daily initially, the serum cortisol was normal after one week, and by 4 months her blood sugar and blood pressure were normal off all other medications. The HBA1c had fallen from 10.7% to 5.4%. Shortly afterwards she became pregnant and on a reduced dose of cabergoline (1.5 mg/week), she delivered a healthy full term baby, echocardiography was normal in both mother and baby.
She has now been in complete remission for more than 4 years on cabergoline 0.5 mg 3 times a week without any side effects.
Conclusion: This case provides an example of successful acute and sustained primary “monotherpy” with initially high dose cabergoline in Cushing’s disease. The additional positive metabolic effects and the lack of significant side effects makes high dose cabergoline monotherapy an attractive first or second line treatment for patients with Cushing's disease.

Open Access Original Research Article

Clinical Features and Prognostic Significance of Endobronchial Sarcoidosis

H. Yanardag, C. Tetikkurt, M. Bilir, S. Demirci, A. Bakır, M. Åženocak

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2015/18441

Aims: Endobronchial involvement may occur in patients with sarcoidosis. Although the prevalence of bronchial abnormalities is high, there are no firm data establishing the clinical features and prognosis of sarcoidosis in these patients. The aim of our study was to define the clinical characteristics and prognosis of patients with endobronchial sarcoidosis.
Methods: Clinical and laboratory findings of 44 patients with endobronchial sarcoidosis and 46 patients without endobronchial involvement seen at our institution, were evaluated retrospectively. The patients fulfilled clinical, radiologic or both features of sarcoidosis supported by the histopathologic evidence of noncaseating granulomas. Six to ten bronchial biopsies were taken from each patient. The sample was considered positive if it demonstrated noncaseiting granulomas with negative bacterial, fungal and mycobacterial cultures.
Results: Bronchial biopsy was more positive in 84% of the abnormal appearing airways, biopsy provided diagnostic tissue in 32% of the normal appearing mucosa. The most frequent bronchoscopic finding was miliary infiltration followed by nodular and erythematous lesions. Serum ACE, serum and urinary Ca levels were higher (51.4±14.3 IU/L vs 37.3±15.1 IU/L, p<0.01; 8.42±3.6 mg/dL vs 10.8±2.9 mg/dL, p<0.01; 244.9±32.4 mg/day vs 379.6±36.8 mg/day, p<0.01) in patients with endobronchial involvement. There was no significant difference between FEV1, FVC, TLC and DLCO/VA. The extrapulmonary organ involvement (p<0.02) and progressive disease (p<0.03) was more frequent in patients with endobronchial disease.
Conclusion: Endobronchial involvement in sarcoidosis appears to be a significant predictive risk factor for progressive disease. Extrapulmonary organ involvement was also higher in these patients contributing to a worse prognosis.

Open Access Original Research Article

Correlation of Body Composition with Pulmonary Function in Adults

Namrata Agarwal, Sandip Meghnad Hulke

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2015/18065

Context: General population has a wide variation in physical activities ranging from the people with sedentary lifestyle to people involved in regular physical activity; there is also variation amongst different age group. All these factors may produce wide variation in body composition and this in turn affects pulmonary function.
Aims: To see the correlation between various PFT parameters and various body composition parameters like body mass index (BMI), the fat percentage of the body mass (fat%), the fat-free mass (FFM), and the fat-free mass index (FFMI).
Settings and Design: Cross sectional study which was done on attendants of the patients visiting AIIMS Bhopal OPD
Methods and Materials: Two hundred and twenty three subjects (152 male and 71 female) in the age group of 18 to 48 years underwent the pulmonary function test and body composition assessment. Body composition was assessed using sex matched prediction equation based on skin fold thickness.
Statistical Analysis Used: Univariate correlation coefficient (Pearson) was used to check the relationship between various PFT parameters and body composition.
Results: In males, Fat percentage showed significant negative correlation with FEV1 (r=-0.198, p=0.014) and FEF 25-75%, p=0.0005). Fat free mas showed non-significant positive correlation with the most of the PFT parameters and fat free mass index showed significant negative correlation with the FEV1(r=-0.164, p=0.04) and PIFR.(r=-0.174, p<0.0001). In females significant positive correlation was seen only between fat free mass and FVC. (r=0.32, p=0.005).
Conclusion: Body composition has a predominant effect on pulmonary function test in males. In females, some effect is also seen. So we recommend body composition assessment for PFT interpretation.

Open Access Original Research Article

Prevalence of Pain in Family Medicine Clinic of Bowen University Teaching Hospital, Ogbomoso, Nigeria

I. O. Amole, A. O. Durodola, A. Adeniran, O. T. Awotunde, S. A. Adesina

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2015/18006

Introduction: Pain is the most common reason for physician consultation in most advanced countries such as the United States. It is a major symptom in many medical conditions, and can significantly interfere with a person's quality of life and general functioning.
Objectives: This study aimed to determine the prevalence of pain among adult patients and to describe the localization, duration and severity of pain in this population.
Methodology: A cross-sectional descriptive survey was used. Consenting participants aged 18 years or older were recruited for the study. Descriptive and pain-specific data were collected using a predesigned interviewer administered questionnaire and the Brief Pain Inventory (BPI). The initial questionnaire elicited information on demographic variables, pain prevalence, and pain characteristics, and the BPI was used to characterize pain further.
Results: A total of 100 subjects participated in the study and the mean age was 44.94±14.92 years. The prevalence of pain (defined as any subject who reported pain as a top or secondary reason for the visit) was 84.0% (95% CI 76.7% – 91.3%). More than one-half (52.4%) of the subjects complained of pains in the lower limbs and back and the duration of pain was less than 6 months in 58.3% of the subjects. More than one-half (54.8%) of the subjects who presented with pain claimed that pain interfere with their walking ability. No significant association was found between socio-demographic characteristic and prevalence of pain.
Conclusion: The prevalence of pain in Family Medicine Clinic of the Bowen University Teaching Hospital, Ogbomoso is very high. It affects mainly the lower limbs and the back and interferes with their walking ability. Majority of them presented with severe pain that is usually less than 6 months.

Open Access Original Research Article

A Methodological Study: Validity and Reliability of the Turkish Version of the Attitudes towards Cancer Scale

Ummu Kacer Daban, Ozden Dedeli, Sezgi Cinar Pakyuz

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2015/17667

Introduction: The 30-item Attitudes Towards Cancer Scale (ATC) is used in English speaking countries to measure attitudes towards cancer patients which has not been validated in Turkish population.
Aims: The aim of this study was to test the validity, reliability, responsiveness and psychometrics of the Turkish ATC (T-ATC) version.
Study Design: It is a methodological study.
Place and Duration of Study: The study took place in a University Hospital, a State Hospital and a Private Hospital in Manisa, Turkey, from April-August 2014.
Methodology: A sample of 300 nurses (263 women, age: 31.5±7.1 years) in three hospitals. The adaptation of the original ATC into Turkish was achieved the guidelines published in the literature. Construct validity was established factor analysis with principal components extraction. Factor analysis with varimax rotation, using Kaiser criterion (eingenvalues > 1.0). The adequacy of internal consistency reliability of the T-ATC was examined with Cronbach’s alpha (α), Spearman Brown split-half value, inter-item correlation. Inter-item correlation of the T-ATC was examined by intraclass correlation coefficients (ICCs).
Results: One-factor structure of the T-ATC was demonstrated by analysis with principal components extraction. As for, internal consistency of T-ATC, it was supported by Cronbach’s alpha (α=0.68), Spearman Brown split-half value (0.57 for the first half and 0.61 for the second half), inter-item correlation was ranged from 0.21-0.46.
Conclusion: The T-ATC showed initial evidence of the reliability and validity that can be used in Turkish speaking countries in order to measure attitudes towards cancer and patients with cancer.

Open Access Original Research Article

Multiple Laryngeal Polyposis; A Newly Introduced Entity: Update

Shawky Elmorsy, Hazem Amer, Hmt Baz

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2015/17773

Introduction: Vocal fold polyps are caused by inflammation caused by stress or irritation. Laryngeal polyp may be a single polyp or more than one polyp affecting one vocal fold or both folds, translucent to red raspberry colored mass.
Materials and Methods: The study group consisted of 40 patients, 32 males and 8 females. The mean age of the patients was 33 years; with a range of 23-55 years, suffering primarily from long standing dysphonia and were diagnosed by an otolaryngologist (Flexible naso pharyngo laryngoscope after application of painless topical anesthesia and rigid endoscopy) and voice pathologist through videostroboscopic analysis. First group, 20 patients had reinke's edema. Second group, 12 patients had unilateral multiple vocal fold polyps. Third group, 8 patients had bilateral vocal fold polyps.
Results: First group Reinke's edema produces a deep, husky sounding voice, it is most commonly caused by tobacco/smoke exposure, but may also be aggravated by gastric reflux, second group, unilateral multiple or diffuse vocal fold polyps caused by intense intermittent voice use/abuse and the third group, bilateral vocal fold polyps and we found that its main etiology is abuse of voice and negligence of medical consultation for long time that leads to more trauma and development of more polyps.
Conclusion: Reinke's edema, unilateral or bilateral multiple vocal cord polyps are a group of benign pathology can be collectively known as multiple laryngeal polyposis. It is a newly mentioned terminology, introduced by authors to describe collectively a picture of appearance of more than one polyp affecting either one or both vocal folds or the picture of classic Rreinke's edema.

Open Access Original Research Article

Early Pregnancy Maternal Hepatocyte Growth Factor and Risk of Gestational Diabetes

Michal Dishi, Karin Hevner, Chunfang Qiu, Neway G. Fida, Dejene F. Abetew, Michelle A. Williams, Daniel A. Enquobahrie

Journal of Advances in Medicine and Medical Research, Page e 1-9
DOI: 10.9734/BJMMR/2015/18632

Aims: We investigated associations of serum hepatocyte growth factor (HGF) with risk of gestational diabetes mellitus (GDM). We also examined whether pre-pregnancy overweight/obesity status or leisure-time physical activity (LTPA) modify these associations.
Methods: In a nested case-control study (173 GDM cases and 187 controls) among participants of a pregnancy cohort, early pregnancy (16 weeks of gestation, on average) serum HGF was measured using enzyme-linked immunoassay. GDM was diagnosed using American Diabetes Association guidelines. Logistic regression was used to calculate odd ratios (ORs) and 95% confidence intervals (CI). Effect modifications by pre-pregnancy overweight/obesity status or LTPA during pregnancy were examined using stratified analyses and interaction terms.
Results: Overall, we did not find significant associations of serum HGF with GDM risk (p-value>0.05). However, compared with women who had low serum HGF concentrations (<2.29 ng/ml), women with high serum HGF concentrations (≥ 2.29 ng/ml) had 3.8-fold (95%CI: 1.30-10.98) and 4.5-fold (95%CI: 1.28-15.80) higher GDM risk among women who were overweight/obese, pre-pregnancy (body mass index≥25 kg/m2), or did not report LTPA, respectively. These associations were not present among women who were not overweight/obese (interaction p=0.05) or reported LTPA (interaction p=0.05).
Conclusion: Overweight/obesity status and LTPA may modify associations of early pregnancy serum HGF with subsequent GDM risk.

Open Access Original Research Article

The Effect of Different Irrigation Regiments on the Push out Bond Strength of MTA Fillapex Sealer to Dentin

Arushi Agrawal, Bonny Paul, Shiv Mantri, Kavita Dube

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2015/18011

Aims: The purpose of this study was to compare the effect of various irrigation regiments on the push out bond strength of MTA Fillapex sealer to dentin.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Conservative dentistry and Endodontics, Hitkarni Dental College and Hospital (HDCH), between November 2014 and December 2014.
Methodology: Thirty single-rooted premolar teeth were taken. Roots were divided into 3 groups according to the irrigation regiment used and instrumented using 5% sodium hypochlorite (NaOCl) or 2% chlorhexidine (CHX) irrigants as chemical auxiliary substances and 17% Ethylenediaminetetraacetic acid (EDTA) or 50% citric acid for smear layer removal. Finally, CHX solution was used as the final irrigant in one group. Root canals were filled with gutta-percha and MTA fillapex (Angelus, Londrina, PR, Brazil),a resin-based sealer. Bond strength was measured by the push-out test. Data were statistically analyzed by Kruskal-Wallis and Mann-Whitney U tests.
Results: In the present study, specimens in G1 (NaOCl + EDTA + Distilled Water) & G2 (CHX + EDTA+ Distilled Water) group show lower push out bond strength values than G3 (NaOCl+ EDTA + Citric Acid +CHX) group.
Conclusion: Thus, within the limitations of this study, we conclude that the different irrigation regiments did affect the push out bond strength of MTA Fillapex sealer to dentin. However the significant changes were not found between the various groups.