Open Access Systematic Review Article

Efficacy of Allergen Specific Immunotherapy for Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis

Madonna Nader Adly, Mahmoud Fawzy Mandour, Mahmoud Foad Abd Elaziz, Magdy Eisa Saafan

Journal of Advances in Medicine and Medical Research, Page 200-213
DOI: 10.9734/jammr/2021/v33i2231172

Background: Allergic rhinitis is a common disease that affect nose causing sneezing, watery nose, nasal itching and redness that affect quality of life, productivity at work or school and may underlies complications (e.g. Asthma) for patients and are often accompanied by itchy eye, redness and lacrimation.

Aim of the Work: The objective of this study is to systematically assess the efficacy and safety of immunotherapy treatment for patients with Allergic Rhinitis.

Method: Our initial search generated a total of 23330 possible relevant titles. Titles, abstracts were preliminary screening so that 22565 were excluded. 154 articles were retrieved in full text the number of studies excluded after assessment of the full text 145, 9 articles met the eligibility criteria and fulfilled the inclusion and exclusion criteria for the review.

Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available on the Internet upto 2018.

Data Extraction: If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion: Our systematic review provides evidence that Sublingual Immunotherapy (SLIT) tablets effectively relieve rhinitis symptoms in adults with allergic rhinitis, improve their quality of life and provide data about safety of Sublingual Immunotherapy as there were no serious side effects of using SLIT tablets. Nevertheless, the current evidence may be limited due to sample size and the heterogeneity between studies. Large sample size and multiple center RCTs on the efficacy of different formulations of SLIT drugs are still needed to provide further evidence and more precise recommendations.

Open Access Opinion Article

Transdisciplinary Clinical Practice between Physiotherapists and Traumatologists in Orthopaedic Medicine

Luis E. López Montoya, Luis Roberto García Valadez, Ángel D. López Montoya, Joceline Sandoval, Diana Yucari López Cabanillas

Journal of Advances in Medicine and Medical Research, Page 85-93
DOI: 10.9734/jammr/2021/v33i2231161

Introduction: The transdisciplinary scope is conceived as an emerging practice and corpus of knowledge since it comes from the interactions between different disciplines. Transdisciplinarity emerges to solve in a more efficient way health problems of humanity that overcome the traditional biomedical interdisciplinary attention model. In this article, the transdisciplinary physiotherapist is exposed as the beginning of an authentic dialogue between the physiotherapist and the traumatologist in the care of the orthopedic patient that includes all treatment phases of integral rehabilitation, as well as its factors to consider the possible advantages and dares that this scope may present to the health services.

Objective: This paper aims to propose to the scientific community the context of transdisciplinary clinical practice between traumatologists and physical therapists.

Methods: It is performed a grounded theory approach to develop a thesis based on our observations and a reflection of literature that intends to explain transdisciplinary clinical practice phenomenon between traumatologists and physical therapists and pose the potential outcomes of this interactions and its implications.

Conclusion: Exist theoretical and practical background to support the clinical practice of transdisciplinary care in Orthopedic and Physical Therapy attention; which make possible professionals to develop transdisciplinary clinical skills, and team shared decision making. Transdisciplinary clinical practice, as with any educational process, should ideally foster specific shared competencies in healthcare professionals, including teamwork, leadership, consensus building, the ability to identify and achieve common patient care goals and variable shared practical skills that may even include other specialization areas.

Open Access Original Research Article

Determining the Impact of Platelet-rich Plasma Therapy on Short-‎term Postoperative Outcomes of Pediatric ‎Tonsillectomy Patients in Egypt

Hadeer Abd El-moneim Saad, Mahmoud Fawzy Mandour, Abo-Bakr Salah Behery, Walaa Abou Sheleb

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/jammr/2021/v33i2231153

Background: Tonsillectomy is considered one of the most common major operations performed in pediatric population. Unfortunately, tonsillectomy is often associated with severe pain that may delay the patient discharge and influence his ability to return to the normal daily activities together with a 2–4% risk of hemorrhage. Among promising healing promoting agents is Platelet-rich plasma (PRP). It is considered as a potential adjuvant therapy improving the healing of surgical wounds and contains multiple growth and healing factors that are released upon their activation.

Methods: This was a prospective randomized controlled study carried on forty patients who underwent tonsillectomy alone or adenotonsillectomy. In each patient, PRP was used on one side " test side " and other side was used as a control. The test side was randomly allocated in all patients, so the results will be of the 40 patients, total sides 80, (test side 40; 20 right side and 20 left side).

Results: Our results revealed that mucosal healing was noted to be better in PRP treated side, particularly on 5th and 10th post-operative day, with documented less incidence of secondary post-operative hemorrhage. Pain scores were less on the PRP treated side through the post-operative period, but were statistically significant only on the 5th day postoperative.

Conclusions: The preliminary results from this study, supported by literature, have revealed that PRP was beneficial in the amelioration of post-tonsillectomy pain, improvement of healing and bleeding risk in pediatric tonsillectomy patients.

Open Access Original Research Article

Noninvasive Bi-Level Positive Airway Pressure Ventilation in Blunt Chest Trauma

Mai Mohammed Mahran, Rehab Said El-Kalla, Ayman Abd El khalek Sallam, Mohamed Ahmed El Heniedy, Hala Mohey El- deen EL- Gendy

Journal of Advances in Medicine and Medical Research, Page 8-15
DOI: 10.9734/jammr/2021/v33i2231154

Background: Chest injury was found to cause death in 20%–25% of multiple trauma patients. Thoracic trauma is, therefore, important in the overall management of multiple injury patients and may require a longer stay in the Intensive Care Unit (ICU) and use of mechanical ventilation.

Methods: This prospective randomized clinical study was in Emergency Intensive Care, Tanta University Hospitals. For, 88 adult patients with blunt chest injury. Patients were enrolled in this study aged ≥18 years old classified into two equal groups: Group I (Non-Invasive Mechanical Ventilation group) = 44 patient: Patients in this group received BIPAP. Group II (Control group=44 patient: Patients in this group have received high flow O2 by mask O2 without use of non-invasive mechanical ventilation. Data of collection were: the demographic data, Frequent arterial blood gas analysis of all patients every 6 hrs. Respiratory rate, Arterial blood pressure, Heart rate were recorded: every 6 h. All Patients receive analgesia. Evaluate outcome: a-Primary outcome. Tracheal intubation, duration of ventilation. b-Secondary outcome. Mortality, ICU length stay. And Chest Trauma Scoring System.

Results: Ten patients (22%) were intubated and mechanically ventilated in group I (BiPAP). with mean value of duration of ventilation 34.4 hrs. But at group II 16   patients (36%) were intubated and mechanically ventilated with mean value of duration of ventilation 34.12 hrs. ICU stay at group I (BiPAP) was statistically decrease of number of days when compared to group II (control). 6 days at group I and 12 days at group II. In this study no case of mortality was recorded with non-invasive ventilation, although three mortality cases were recorded with the control group.

Conclusion: This study recommends the pre-emptive use of Non-Invasive Ventilation in the treatment for blunt chest injury in patients at risk for respiratory failure. Success of Non-Invasive Ventilation depends on improvement of hypercarbia and hypoxemia in patients impending respiratory failure due to reversible cause as blunt chest trauma with the expectation of a good outcome and avoidance of intubation.

Open Access Original Research Article

The Effects of Magnification and Operator’s Experience on the Quality of Preclinical Dental Procedures

Danielle Wajngarten, Júlia Margato Pazos, Patricia Petromilli Nordi Sasso Garcia

Journal of Advances in Medicine and Medical Research, Page 16-23
DOI: 10.9734/jammr/2021/v33i2231155

Aims: This study evaluated the effect of magnification on the quality of preclinical class I cavity preparations according to operator’s experience.

Methodology: This was an experimental laboratory study. The response variable was the quality of Class I cavity preparations evaluated by the Class I Cavity Preparation Assessment - COCA. Class I cavity preparations were performed in all artificial first molars under four conditions: unaided visualization, using a simple loupe, using a Galilean loupe, and using a Keplerian loupe (N=640). The two-factor analysis of variance was performed (α=0.05).

Results: No interactions between operator’s experience and magnification device were found (p>0.05). Although, higher quality scores were given to cavity preparations in tooth #36 using the Galilean loupe compared to naked eye (p<0.01). The more experienced operator received higher quality scores for tooth #46 regardless of the magnification system used (µexperienced=7.0±2.3 and µinexperienced=5.4±2.4).

Conclusion: The use of magnification devices did not influence the quality of class I cavity preparations performed on tooth #16, 26, 46. Galilean loupe was associated with improved quality of the cavity preparation performed on tooth #36, and the operator’s experience influenced the quality of the preparation on tooth #46.

Open Access Original Research Article

The Preferred Premedication Order to Prevent Infusion Reactions in Patients with Breast Cancer Receiving Pertuzumab Plus Trastuzumab and Docetaxel

Shigeru Nakagaki, Ryoichi Matsunuma, Kei Yamaguchi, Ryosuke Hayami, Michiko Tsuneizumi

Journal of Advances in Medicine and Medical Research, Page 24-30
DOI: 10.9734/jammr/2021/v33i2231156

Aims:Pertuzumab plus trastuzumab and docetaxel is a standard regimen for human epidermal growth factor receptor 2 (HER2)-positive breast cancer in the metastatic, adjuvant, and neoadjuvant settings. Infusion reaction represents one of the common side effects of anti-HER2 agents. There is no standard premedication to prevent infusion reactions, although antihistamines, acetaminophen, and/or corticosteroids are often used for this purpose. This study evaluated the ability of premedication to prevent induction reactions in patients receiving pertuzumab, trastuzumab, and docetaxel.

Methods: This retrospective, single-institute study assessed infusion reactions in 72 women with HER2-positive early breast cancer who received pertuzumab, trastuzumab, and docetaxel between November 2018 and April 2021. Thirty-six patients received premedication consisting of oral acetaminophen prior to pertuzumab and trastuzumab administration and dexamethasone and D-chlorpheniramine maleate intravenously prior to docetaxel administration (previous regimen). Thirty-six patients received premedication consisting of acetaminophen, dexamethasone, and D-chlorpheniramine maleate sequentially prior to pertuzumab, trastuzumab, and docetaxel administration (current regimen).

Results: The rates of infusion reaction after the initial injection were 55.6 and 16.7% in the previous and current regiment groups, respectively (p = 0.001). Trastuzumab more frequently caused infusion reactions than pertuzumab and docetaxel. Chills, vomiting, and nausea were the major symptoms of infusion reactions.

Conclusion: Premedication featuring the upfront use of dexamethasone and D-chlorpheniramine maleate prior to the administration of anti-HER2 targeted agents significantly prevented infusion reactions.

Open Access Original Research Article

Assessment of the Effect of Acid and Base Cycling on Mechanical Properties of Various Esthetic Restorative Materials

Horieh Moosavi, Fatemeh Rezaei, Zahra Rezaei, Zahra Soroush

Journal of Advances in Medicine and Medical Research, Page 31-38
DOI: 10.9734/jammr/2021/v33i2231157

Objective: The purpose of this study is the evaluation of the effect of pH cycling, including both acidic and alkaline environments, on the mechanical properties of tooth-colored restorative materials.

Methods and Materials: 20 rectangular bar specimens of one bulk-fill restorative composite, two conventional nanohybrid restorative composites, and one restorative resin-modified glass ionomer were produced according to ISO 4049. Half of the materials were stored in an acid and base cycling defined as two-day storage in acidic (pH =4) and alkaline (pH=8) solutions. The rest of the materials were incubated in distilled water as a control group. The storage lasted for 48 days. Finally, flexural strength, elastic modulus, and microhardness of the specimens in each group determined. Data analyzed with Kruskal-Wallis, Dunn, MANOVA, Tukey HSD and T-test. 

Results: The pH cycling model had a significant influence on all mechanical properties of the bulk-fill restorative composite and resin-modified glass ionomer than those stored in water (P <0.05). One of the conventional nanohybrid restorative composites showed a significant reduction in elastic modulus and microhardness while the other one showed a significant reduction only in flexural strength. 

Conclusion: pH cycling negatively affects the mechanical properties of resin composites, and the materials’ composition is an important factor in the degradation of the resin-based materials examined.

Open Access Original Research Article

Effect of Consuming Milk Tea with Stevia on Plaque pH among Dental Students: Cross-Over RCT

CM Marya, Mandeep Kaur Sandhu, Ruchi Nagpal, Sakshi Kataria, Pratibha Taneja, Vandana Marya

Journal of Advances in Medicine and Medical Research, Page 59-69
DOI: 10.9734/jammr/2021/v33i2231159

Background: Stevia is a natural, healthy, unconventional replacement to the table sugar and artificial sweetener. Phytochemicals present in it exerts an influence on the microbial flora of the mouth. Hence, study was planned to compare the effects of stevia with different sugars on the plaque pH.

Methodology: The present study was carried in department of Public Health Dentistry between 9am-12pm. It was a triple blinded Crossover Randomized Controlled Clinical Trial with LSD design. All the 40 subjects were exposed to all four interventions sequentially, at weekly intervals with 1 week wash out period. (Intervention: A- Table sugar, B- Jaggery, C- Stevia, D- Milk tea without sugar). Inferential statistics was done using Repeated measures of ANOVA followed by Post hoc pairwise comparison and Three-way RMANOVA to determine relationship between SUGAR * WEEK * TIME interaction. Level of significance was set at p value at 0.05.

Results: Plaque pH assessments were performed at 4 points of time intervals (at baseline, 1 min, 20min, 60 min). Overall significance differences were seen in plaque pH at different time intervals for all interventions. Intergroup comparison showed potential efficacy of stevia in maintaining plaque pH.

Conclusion: In the present study, it was found that stevia has the least cariogenic potential when compared with jaggery and refined sugar. Jaggery also did not show a significant reduction in plaque pH. Therefore, Stevia and Jaggery can be compared for their anti-cariogenic properties. This study has been registered under the Clinical Trial Registry of India CTRI/2020/12/03003

Open Access Original Research Article

Atrial Fibrillation as a Predictor of In-Hospital Outcome in Patients with Acute Coronary Syndrome Treated by Primary Percutaneous Coronary Intervention

Mahmoud A. Saad, Ahmed F. Alarag, Randa M. Abdul Mageed, Seham F. Badr

Journal of Advances in Medicine and Medical Research, Page 70-84
DOI: 10.9734/jammr/2021/v33i2231160

Objectives: to study the relation between atrial fibrillation (AF) and in-hospital outcome in patients with acute coronary syndrome (ACS) who were treated by primary percutaneous coronary intervention (PCI).

Methods: This study was conducted on 80 patients admitted with ACS and treated with primary PCI at cardiovascular medicine department Tanta university hospitals starting from January 2020 till January 2021. The primary end points are all cause mortality and major adverse cardiovascular events (MACE) including a composite of death, nonfatal re-infarction, target vessel revascularization (TVR), new onset congestive heart failure, contrast induced nephropathy (CIN), or stroke during hospitalization. Patients was divided into 2 groups: Group 1: consisted of 40 consecutive AF-patients treated by primary PCI. Group 2: consisted of 40 consecutive sinus rhythm-patients treated by primary PCI.

Results: Patients in AF group showed significantly older age, lower systolic and diastolic blood pressure, higher heart rate, higher Killip class II-IV, more inferior STEMI presentation, higher CK-MB, more RCA as infarction related artery, more moderate to sever mitral regurgitation, more patient developed congestive heart failure during hospitalization, and higher overall MACE during hospitalization.

Univariate and multivariate regression analysis were performed to investigate the possible predictors of AF in the study population. In univariate regression analysis, older age, higher CKMB level, higher degree of mitral regurgitation, enlarged left atrium, and RCA as infarction related artery were correlated with AF. In the multivariate regression analysis, using model adjusted for aforementioned parameters, older age, higher CK-MB level, enlarged left atrium diameter, and RCA as infarction related artery independently predicted AF.

Univariate and multivariate regression analyses were performed to investigate the possible predictors of overall in-hospital MACE in the study population. In univariate regression analysis, smoking, Killip II-IV, high creatinine level, lower ejection fraction, higher end systolic diameter, and AF were correlated with MACE. In the multivariate regression analysis, using model adjusted for aforementioned parameters, Killip II-IV, higher creatinine level, and AF independently predicted MACE.

Conclusion: Patients older in age, with higher CK-MB level, enlarged left atrial diameter, and RCA as infarction related artery had higher incidence of AF during ACS. Patient with AF who presented with ACS had a higher incidence of heart failure during hospitalization. The independent predictors of MACE in our study were AF, Killip II-IV, and higher creatinine level.

Open Access Original Research Article

Cerebroplacental Ratio on Doppler as a Predictor of Fetuses at Risk of Perinatal Complications

Salwa Abdelmaged Elraey, Mohammed Mohsen Elnamoury, Ahmed Mohammed Othman, Ahmed Mahmoud Awara

Journal of Advances in Medicine and Medical Research, Page 120-131
DOI: 10.9734/jammr/2021/v33i2231164

Background: Doppler velocimetry is the best method of surveillance for fetal hypoxemia during pregnancy. Cerebroplacental ratio (CPR), has been suggested as a useful clinical simplification. It is believed that the CPR better predicts adverse perinatal outcomes than its individual components and better than conventional anthropometric models. Therefore, the aim of this study is to evaluate the significance of the cerebroplacental 10th centile threshold measured weekly from 36 weeks of gestation till delivery as a screening test for prediction of need for Cesarean section for intrapartum fetal compromise and the adverse neonatal outcome in women with normally grown fetuses and uncomplicated pregnancy.

Methods: This study was carried out on 40 pregnant women uncomplicated, singleton pregnancy with appropriately grown fetuses on clinical assessment. The last Doppler indices including cerebroplacental ratio measurement obtained before labor was reported. CPR values below 1.1 were reported as abnormal. Various studies have variably defined the threshold of abnormal CPR ratio as <1.08.

Results: There was significant decrease in the Mean of CPR among patients who had anemia compared to those without anemia. In addition, there was no significant association seen between low CPR and having previous history of abortion or IUGR as well as being a smoker. There was no significant difference between cases who had normal and abnormal CPR regarding gestational age at delivery. There was no difference between cases who had normal and abnormal cerebroplacental ratio regarding mode of delivery. there was significant decrease in the prevalence of low birth weight among group who had CPR≥1.08. CPR <1.08 was significantly associated with neonatal complication like NICU admission, and neonatal death. There was no statistically significant relationship between cerebroplacental ratio and neonatal complication like IUFD, and neonatal sepsis. There was no statistically significant association between the mean cerebroplacental ratio and IUFD. There was statistically significant association between the mean cerebroplacental ratio and NICU. There was no statistically significant association between the mean cerebroplacental ratio and neonatal sepsis. The mean cerebroplacental ratio of 0.93± 0.22 has a significant association with neonatal death.

Conclusion: A low cerebroplacental ratio reflects redistribution of the cardiac output to the cerebral circulation and has been shown to improve accuracy in predicting adverse outcome compared with Middle cerebral artery (MCA) or Umbilical artery (UA) Doppler alone. Therefore, integrating CPR in clinical management may help to better identify fetuses at risk for adverse perinatal events, since abnormal CPR has been associated with an increased risk of perinatal complications.

Open Access Original Research Article

Maternal and Fetal Response to Pre Anesthetic ‎Magnesium Sulphate in Cesarean Section

Mayada Hady Sokeer, Sameh Mohammed El-Shehdawy, Shaimaa Farouk AbdelKader, Ashraf‏ ‏‎ El-Sayed EL-Zeftawy

Journal of Advances in Medicine and Medical Research, Page 132-141
DOI: 10.9734/jammr/2021/v33i2231165

Background: Magnesium, the fourth most common cation in the body, has an ‎antagonistic effect at the N-methyl-D-aspartate (NMDA) receptor, as ‎well as calcium-channel blocker properties. Antagonism at the ‎NMDA receptor is thought to alter the mechanism of central ‎hypersensitivity and to subsequently decrease analgesic requirements ‎including opioid consumption.‎‎ This study aimed to assess the effects of preoperative administration of intravenous magnesium sulphate on the intubation stress response as a primary outcome and uterine, fetal middle cerebral and umbilical arterial blood flow, Apgar score and postoperative analgesia as secondary outcomes in participants undergoing elective caesarian section under general anesthesia.

Methods: This prospective randomized controlled double blinded study ‎was carried out on 65 pregnant females between 21-35 years old undergoing elective caesarian section under general anesthesia. who were randomly classified randomly into two groups: Magnesium sulphate (Mg) group: received 25 mg/kg magnesium sulphate in 100 ml isotonic saline over 10 minutes before induction of anesthesia. Control group (C):  received the same volume of isotonic saline over the same period.

Results: Heart rate and mean arterial blood pressure were decreased significantly at post induction to the end of surgery in mg sulphate compared to control group and was insignificantly different between the studied groups at T0 and T1. VAS was significantly lower in mg sulphate group compared to control group at 1, 2, 4, 8, 12 and 24 hours and was insignificantly different among the two groups at PACU admission and 30 min. preoperative administration of magnesium sulphate (25 mg/kg) was associated with lower postoperative pain scores, less post-operative analgesic consumption, better hemodynamic stability without significant difference in umbilical, middle cerebral and uterine arteries blood flow or Apgar score compared to control group in patients undergoing cesarean section under general anesthesia. There was no statistically significant difference in the incidence of sedation and hypotension. No cases showed respiratory depression in the two groups.

Conclusion: Preoperative administration of ‎magnesium sulphate (25mg/kg) was associated with better ‎hemodynamic stability, lower postoperative pain scores, less post-‎operative analgesic consumption without significant difference in ‎umbilical, middle cerebral and uterine arteries blood flow or Apgar ‎score with nil complications except for PONV compared to control ‎group in patients undergoing cesarean section under general ‎anesthesia.‎‎

Open Access Original Research Article

Brazilian Version of the Dental Environment Stress Questionnaire

Cristina D. Presoto, Ingrid Mertens Silva, Danielle Wajngarten, Filipa Pimenta, Juliana A. D. B. Campos, Júlia M. Pazos, Patrícia A. S. Domingos, Patrícia P. N. S. Garcia

Journal of Advances in Medicine and Medical Research, Page 142-152
DOI: 10.9734/jammr/2021/v33i2231166

Aims: To perform cross-cultural adaptation of the Dental Environment Stress Questionnaire (DES) for use in Portuguese-speaking populations, evaluate its psychometric properties, and determine the effects of gender and educational level in the perception of stress sources in dental students.

Methodology: An observational cross-sectional study design was implemented to examine face and content validity. 466 Brazilian students participated in the study in 2015 (UNESP students response rate=79.2%; UNIARA students response rate=82.4%). Construct validity was assessed via the determination of factorial, convergent, and discriminant validity. Reliability was estimated using Cronbach's α, and composite reliability. A model was designed using structural equation modeling, to verify the effects of gender and educational level on the perception of stress sources.

Results: The complete model purposed was not a good fit to the sample (λs=0.358–0.955, ꭙ2/df=3.36, CFI=0.881, TLI=0.870, RMSEA=0.071, r=0.426–0.664, AVE=0.366–0.856).  After the removal of item 12 and insertion of a correlation between the errors for items 1 and 2 (LM=399.154) and Items 14 and 16 (LM=146.216) the model fitted the sample (λs=0.411–0.955, ꭙ2/df=2.54, CFI=0.926, TLI=0.919, RMSEA=0.058, AVE=0.363–0.850).  Adequate content validity ratios were observed for 23 items. Gender affected all DES factors, and educational level influenced four factors.

Conclusion: Cross-cultural adaptation process provided an instrument that was easy to understand, with adequate idiomatic and cultural equivalence. The Portuguese version of the DES showed good psychometric properties and reliability in the study sample. Gender and educational level exerted significant effects on seven and four factors, respectively.

Open Access Original Research Article

Impact of Surgery in De Novo Metastatic Breast Cancer after Systemic Disease Control

Rufina Soomro, Afsheen Javaid Khokher, Naila Zahid

Journal of Advances in Medicine and Medical Research, Page 153-161
DOI: 10.9734/jammr/2021/v33i2231167

Background: Systemic chemotherapy is the standard of care for patients with metastatic breast cancer, with an undecided role in surgery. Limited data is available for the role of surgery on the overall survival of stage 4 breast cancer regarding luminal subtypes of patients. This is a retrospective data analysis comparing overall survival benefit and disease-free survival in stage IV breast cancer after systemic treatment and systemic disease control concerning luminal classification in the last five years.

Method: Patients who had surgery and no surgery after systemic treatment and disease control were compared for 5 years overall survival as the primary endpoint and disease-free survival as the secondary endpoint. The survival benefit was also compared regarding tumor biology (ER/PR, HER2 status).

Results: Data included 421 patients, 237 in surgery and 184 in no surgery group. At one year survival for surgery performed and not performed was not significant. Five-year overall survival for surgery performed and not performed was 84.4% and 74.5%. A statistically significant difference in survival rates was observed (p<0.0001). The mortality rate was 15.6% in surgery performed and 25.5% in the no-surgery group which showed a significant difference among the two study groups (p=0.011). We found statistically significant differences in luminal B (p=0.004) and triple-negative breast cancer patients (p=0.001) for survival rates in surgery performed and not performed groups.

Disease-free survival has shown no significant difference in surgery performed and not performed group in 1, 2, and 5 years follow-up.

Conclusion: Surgery has a positive impact on overall survival in Stage 4 patients with systemic disease control even in high-risk luminal B, Her 2 Positive, and triple-negative breast cancer patients. There was no significant difference observed in disease-free survival who were operated on or not. However, there was no local recurrence in the operated group.

Open Access Original Research Article

Protective Effect of Resveratrol against the Alveolar Bone Loss in Rats with Experimental Periodontitis and Acts Positively on the IL-17

JordanaHeidemann Pandini, Lais Fernanda Pasqualotto, Pedro Henrique de Carli Rodrigues, João Paulo Gonçalves de Paivaa, Patricia Oehlmeyer Nassar, Carlos Augusto Nassar

Journal of Advances in Medicine and Medical Research, Page 162-173
DOI: 10.9734/jammr/2021/v33i2231168

The resveratrol is a polyphenol known for its health benefits, which includes the ability to interfere in the osteoblastogenesis, which may foster adverse immunomodulators effects in the host response to periodontal disease. In the present study we evaluated the appearance of periodontal tissues of rats with experimentally induced periodontitis, by using resveratrol. Twenty-four male Wistar rats were used, in which half of the animals received a ligature around the first lower molars, then forming the groups with experimental periodontitis. Next, four groups were created: 1) Control Group (CON); 2) The Ligature Group (LIG); 3) Group Resveratrol (RSV); 4) Ligature-Resveratrol Group (LIG-RSV). The animals of the Resveratrol groups were daily dosed with 10 mg/kg of body weight of polyphenol orally, during four weeks. After 105 days of experimental period, euthanasia was performed. The results showed a significantly lower alveolar bone loss (p<0.05) in animals that received resveratrol, and still, the polyphenol was able to reduce concentration of interleukin 17 (IL-17) in the groups dosed with it. Our conclusion is that dosing rats with experimental periodontitis with resveratrol could cause a protective effect on the alveolar bone loss, in addition to act positively on the IL-17.

Open Access Original Research Article

The Experience with a Surgical Camp in a Rural Hospital in Northern Uganda

Richard Wismayer

Journal of Advances in Medicine and Medical Research, Page 174-179
DOI: 10.9734/jammr/2021/v33i2231169

Introduction: In Sub-Saharan Africa, surgical conditions remain neglected in its health care systems. This results in a low surgical output from district hospitals with many patients referred to Referral Hospitals in the region. Therefore surgical camps in district hospitals are often necessary where volunteer surgical teams perform a wide range of mostly elective surgical procedures. These surgical camps are pre-planned activities carried out at no cost to the patients who belong to poor and hard to reach vulnerable communities. The purpose of this surgical camp was to offer free specialised surgical service in a rural hospital and hence improve surgical access to a poor vulnerable community in Northern Uganda. Training basic surgical skills and the provision of continuous medical education to medical officers in the region was also part of the objective of this surgical camp.

Methods: A descriptive study using data collected from a one week surgical camp in the year 2011 was performed at St. Joseph’s Maracha Hospital. Data from operating log forms regarding date of procedure, patient gender, clinical diagnosis, operation performed and type of anaesthesia was obtained. Data was analysed for age, sex, type and rate of surgical procedure and type of anaesthesia. The participants’ involved specialist general surgeons, medical officers, clinical officers, theatre nurses and anaesthetists.

Results: In total, 105 surgical procedures were performed during the 7-day-long camp. Mean age of the patients was 39.54 years. The male: female ratio was 1:0.38. Adult inguinal herniorrhaphy formed 68.6% of all surgical procedures.

Conclusions: The bulk of surgical disease encountered during the camp were inguinal hernias. Surgical camps improve access to surgical care to vulnerable hard to reach populations and should become an integral part of health service delivery in rural Africa.

Open Access Original Research Article

Evaluation of Pathogenic Potentials of Microbial Contaminants from Naira Notes in Nigeria

Ifeoma Bessie Enweani, Chinyere Nkemjika Anyanwu, Emmanuel Ifeanyi Obeagu

Journal of Advances in Medicine and Medical Research, Page 180-188
DOI: 10.9734/jammr/2021/v33i2231170

The study was done to determine burden of fiat currencies. A total of Six hundred and twenty four pieces of different denominations of naira notes obtained from banks in Enugu metropolis and samples of nose swabs aseptically collected from fifty two note counters from those banks were examined for similar bacterial and fungal contaminants. All sequences were identified using the Basic Local Alignment Search Tool (BLAST) on National Center for Biotechnology Information (NCBI) website. While the fungi amplicons yielded DNA bands of approximately 650 base pair, that of the bacterial isolates were approximately 850 base pair. Proteus mirabilis (NR11449.1) and Escherichia coli (LN831043.1) were identical and selected from the bacterial category while Aspergillus fumigatus (MK910068), Aspergillus flavus (JQ860302) and Aspergillus niger (MK461093) were identical and selected from the fungal category. Rats inoculated orally with Escherichia coli and Proteus mirabilis presented with watery stool and reduction of weight by 16+0.4g after two weeks of commencement of inoculation. They showed reduction in activity and reduced locomotion when compared with the control. There were no physically observable changes in the other test groups. In the hematological investigation, the mean PCV in % were 39±1.0 for the E. coli, 40±0.4 for P. mirabilis, 35±0.2 for A. niger, 40±0.7 for A. fumigatus and 37±0.1 for A .flavus. These varied significantly at p<0.05 with the control which has mean PCV of 45±0.3. The differential leucocyte count showed a marked increase in the % neutrophil (E. coli 73±0.1, P. mirabilis 70±0.1, A. niger 78±1.1, A. fumigatus 59±0.3 and A. flavus 62±1.0) when compared with the control rats with percentage neutrophil of 20±0.2. There was also an increase in the white blood cell count of the test groups when compared with the control. Histopathological study of the lungs of the rats inoculated nasally with Aspergillus niger showed necrosis of the alveolar epithelium. This study has shown that naira notes could be a reservoir of microorganisms of medical importance which in turn could become vectors for the transmission of diseases in the society.

Open Access Original Research Article

Association between Caffeine Citrate and Incidence of Acute Kidney Injury in Preterms

Halah Tarek Mohammed Mansour, Hamed Mohamed Mohamed Elsharkawy, Sahar Mohey Eldin Hazzaa, Mohammed Abd-Ellatif Nassar

Journal of Advances in Medicine and Medical Research, Page 189-199
DOI: 10.9734/jammr/2021/v33i2231171

Background: As a result of prematurity, Acute kidney injury (AKI) occurs commonly in preterm neonates and is associated with increased morbidity and mortality. (AKI) is defined as a rapid, potentially reversible deterioration in renal functions sufficient to result in accumulation of nitrogenous wastes in the body.

Aim of the Study: the aim of this study was to determine whether preterm neonates who took caffeine citrate from the first day after birth were less likely to AKI within the first 7 days.

Patients and Methods: This case control study was conducted on 100 preterm neonates at Neonatal Intensive Care Units (NICUS), Pediatric Department, Tanta University with gestational age less than (30 weeks) were grouped into group A and B. Group A 50 preterm neonates who received caffeine citrate from the first day after birth with dose (20 mg/kg) loading dose, and (5 mg/kg/dose) every 24hrs of maintenance dose, given as slow intravenous infusion over twenty to thirty minutes for a week. Group B 50 preterm neonates who did not receive caffeine citrate.

Inclusion Criteria: all preterms <30 weeks admitted within first 24 hours after birth presented by respiratory distress according to Downes score.

Exclusion Criteria: newborns with congenital heart disease except non-significant PDA, neonatal mortality < 48 h of life, clinical signs suggest chromosomal anomalies, newborns with congenital renal anomalies.

  • Hematological Investigations: serum albumin, serum creatinine, blood urea.
  • Urinary Investigations: measuring urine output.

Results: There was a statistically significant difference between the two studied groups as regard serum creatinine in day (5,7) (p<0.001), urea in day 7 (p value <0.001), serum albumin in day (5,7) (p value ≤ 0.05), urine output in day (4,5,6,7) (p value ≤0.05), AKI incidence (p value <0.001).

Conclusion: Caffeine Citrate administration in preterm neonates from the first day of life for one week was associated with reduced occurrence and severity of AKI.

Open Access Original Research Article

Factors Influencing Adherence to Self-Care Practices Among Diabetes Patients in a Selected Tertiary Hospital, Osun State

Arogundade, Toliah Abiodun, Salawu, Rasidi Akinade

Journal of Advances in Medicine and Medical Research, Page 214-229
DOI: 10.9734/jammr/2021/v33i2231173

Aims: Diabetes is a chronic non-communicable disease with many irreversible complications that can be prevented by strict adherence to self-care practice. This study aims to investigate the factors influencing adherence to self-care practices among diabetes patients

Study Design: This study adopted a descriptive research design carried out among diabetes patients attending outpatient endocrinology clinic of Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State between July and September 2021.

Methodology: Sample size was calculated using Cochran formula and total number of sample used were two hundred and eight (208) diabetes patients. Samples were selected using convenient sampling technique. A self-developed structured Questionnaire on knowledge of diabetes and factors influencing adherence to diabetes self-care practices with reliability index of 0.858 and 0.863 respectively. Two (2) adapted questionnaire; Diabetes self-care practices by Schmitt et al (2013) and Level of adherence to self-care practices scale by Morisky et al. (1986) with reliability index of 0.731 and 0.851 respectively were also used for data collection. Data collected were analyzed using descriptive statistics of frequency, percentage, mean and standard deviation while inferential statistics of Pearson product moment correlation and regression were used to test stated hypotheses at 0.05 level of significance.

Results: The result from the study revealed good knowledge of diabetes mellitus and diabetes self-care practices among the respondents. The results also revealed high level of adherence to diabetes medication, diet, physical activity, blood glucose testing, follow-up and foot care. Factors influencing the level of adherence with diabetes self-care practices include cost of treatment, longer year of being diagnosed, good relationship between healthcare team, level of education, good family and social support. There is also a significant relationship between knowledge of diabetes mellitus and adherence with physical activity (r = 0.210; P = 0.02) and blood glucose testing (r = 0.203; P = 0.003). However, there is no significant relationship between knowledge of self-care practices and adherence to self-care practices; socio-demographic characteristics of age (r = -0.040; P = 0.568), education (r = 0.112; P = 0.107) and adherence to self-care practices.

Conclusion: The study concluded that there was high level of knowledge about diabetes and diabetes self-care practices as well as adherence to diabetes self-care practices, therefore, health care providers should continue to monitor self-care practices among diabetes patients to achieve positive health outcome and reduce morbidity and mortality associated with diabetes mellitus.

Open Access Original Research Article

Reproductive Endocrinologic Pattern in Infertile Black Women with Polycystic Ovarian Syndrome

Tawaqualit Abimbola Ottun, Faosat Olayiwola Jinadu, Ayokunle Moses Olumodeji, Adeniyi Abiodun Adewunmi, Fatimat Motunrayo Akinlusi, Haleema Folashade Olalere, Fatai Tijani

Journal of Advances in Medicine and Medical Research, Page 230-236
DOI: 10.9734/jammr/2021/v33i2231174

Background: Polycystic ovarian syndrome (PCOS) is a very common endocrine cause of infertility affecting about 10% of women of reproductive age. We evaluated the pattern of reproductive hormones in infertile Nigerian women with PCOS.

Methods: This was a prospective cross-sectional study at the Lagos State University Teaching Hospital over a 6-month period in which One hundred and fifty infertile women, with diagnosis of PCOS using the Rotterdam’s criteria, had quantitative assessment of their reproductive hormones like Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Progesterone, Testosterone, Prolactin and Thyroid Stimulating Hormone (TSH), with relevant socio-demographic and clinical data noted in the study proforma. Z test, chi-square and correlation tests were used as appropriate to analyse the data with p<0.05 significance level.

Results: The mean age of infertile women with PCOS was 26.50±4.4years; all the women had either oligomenorrhea (62%) or secondary amenorrhea (38%), 56.5% were obese and 33.3% had hirsutism. While 37.7% of the women had abnormally elevated serum LH, 16.4% had high serum FSH, 39% had LH:FSH ratio> 2.5, 96% had low serum progesterone, 29% had high serum prolactin, 17.4% had high serum TSH values and 92% had features of polycystic ovaries on trans-vaginal ultrasound. Correlation of age and BMI with serum FSH, LH and prolactin values were weak and insignificant.

Conclusion: PCOS is common among young Nigerian women presenting for infertility treatment; with dominant features of oligomenorrhea and polycystic ovaries. Hormonal abnormalities are common, varied and not associated with other clinical characteristics.

Open Access Original Research Article

Antiplatelet Effect of Aspirin in Ischemic Stroke: A Hospital-based Study

Masaraf Hussain, Yookarin Khonglah, S. R. Sharma, Baia Synmon, Yasmeen Hynniewta

Journal of Advances in Medicine and Medical Research, Page 237-244
DOI: 10.9734/jammr/2021/v33i2231175

Introduction: Aspirin is widely used for the treatment of stroke. Therefore aspirin resistance can lead to a significant increase in the burden of stroke. Platelet aggregation studies can evaluate platelet function, and this may help to detect anti-platelet resistance.

Methods: This is a hospital-based study of the antiplatelet effect of aspirin in ischemic stroke, during a duration of one year.

All first-time ischemic stroke patients >18 years of age were included. Platelet aggregometry test was done by LTA (Light transmission optical aggregometer), after starting the patients on oral aspirin.

Results: A total of 113 ischemic stroke patients were included for the antiplatelet effect of the aspirin study.  Aspirin resistance was found in 18.58% of patients. Patients with aspirin resistance had higher mortality, and less improvement on follow-up, as compared to aspirin-sensitive patients. They had more incidence of smoking, alcohol abuse, diabetes mellitus, and dyslipidemia, as compared to the aspirin-sensitive group. The results reveal that there is a non-statistically significant trend in both mortality and prognosis between the two study groups compared: aspirin-resistant versus aspirin-sensitive patients.

Conclusion: Aspirin resistance can lead to loss of functional improvement and more mortality than aspirin-sensitive patients. However, further study for drug interactions, adequate risk factor control, the genetic profile of the population is needed, to come to a definite conclusion.

Open Access Original Research Article

Objective Evaluation of Efficacy of Decortication in Chronic Pleural Empyema in Adult Patients

Samar Ahmed Elrashedy, Mohamed Abd Elrahman Elgariah, Mohamed Mahmoud Abo Elnasr, Ehab Abd Elmoneim Wahb

Journal of Advances in Medicine and Medical Research, Page 245-252
DOI: 10.9734/jammr/2021/v33i2231176

Background: Chronic pleural empyema (CPE) is the last phase of the triphasic process of pleural empyema development. Lung decortication is the corner stone in management of chronic empyema. This study aimed to objectively evaluate the efficacy of conventional decortication operation in chronic pleural empyema in adult patients. Also to prove that decortication of variable sizes of chronic empyema thoracis lesions is followed by improvement considering respiratory impairment.

Methods: This prospective clinical study was conducted on 103 patients undergoing elective lung decortication operation for management of chronic empyema. All patients were subjected to the history taking, general examination, chest examination, computed tomography (CT), pulmonary function test and arterial blood gases. Postoperative evaluation was done in outpatient clinic 6 months post operatively including: Full clinical examination, investigations (acute phase reactants, CT chest, PFT and arterial blood gases.

Results: Total leucocytic count, ESR 1st hour, ESR 2nd hour and CRP were significantly decreased in post than pre. FEV1 and FVC were significantly increased in post than pre (P <0.001). FEV1 / FVC Ratio was significantly decreased in post than pre (P <0.001). Transverse and antero-posterior diameters of affected hemithorax were significantly increased in post than pre (P <0.001, 0.019 respectively). Transverse and antero-posterior diameters of normal hemithorax were insignificantly different between post and pre. PaO2 and SpO2 were significantly increased in post than pre (P <0.001). PaCO2 was significantly decreased in post than pre (P <0.001).

Conclusions: The improvement in the lung function, arterial blood gases, transverse and antero-posterior diameter of affected and normal hemithorax was proposed to have resulted from the decortication in chronic empyema thoracis. Decortication of variable sizes of chronic pleural empyema lesions is followed by objective improvement considering respiratory impairment.

Open Access Original Research Article

Assessment of Lingual Nerve Paresthesia after Removal of Mandibular Third Molar

V. Usha, G. Rajabackiyam, K. Prabhu Sankar, Varun Muthuraman, Aravind Christo, . Rajapandian

Journal of Advances in Medicine and Medical Research, Page 253-259
DOI: 10.9734/jammr/2021/v33i2231177

Surgical removal of impacted mandibular third molars are the most commonly performed minor surgical procedures by maxillofacial surgeon. If not treated can lead to few complications like pericoronitis, root resorption of second molar, caries of second molar, cyst and tumours can arise from them. The common complications include swelling, hematoma, trismus and lingual nerve injuries. In this article 1000 cases of various types impactions were surgically operated and assessment of lingual nerve injury was done.

Open Access Original Research Article

Fibrin Monomer in Chronic HCV ‎Cirrhotic Patients

B. B. CH. Eman Ram, M. A. M. D. Sherief, S. M‎. Wesam, K. Z. Mohammed

Journal of Advances in Medicine and Medical Research, Page 260-269
DOI: 10.9734/jammr/2021/v33i2231178

Background: Cirrhosis is a diffuse pathophysiological state of the liver that is thought to be the final stage of various liver injuries. It is characterized by chronic necroinflammatory and fibrogenetic processes, which result in the conversion of normal liver architecture into structurally abnormal nodules, dense fibrotic septa, concomitant parenchymal exaustment, and liver tissue collapse.

Aim of this Work is to study fibrin monomer in chronic HCV patients with and without portal hypertension aiming to investigate its value in these patients and if it aides in early detection of thrombus formation.‎

Patients and Methods: They were fifty chronic HCV cirrhotic patients with and ‎without portal hypertension. Patients of these study were selected from Tropical and internal medicine departments and investigated at Clinical Pathology department in Tanta University hospitals, Faculty of Medicine, Tanta University during the period from July 2018 to January 2020.

Results: The individuals included in this study were comprised as: Group 1: Twenty-five healthy volunteers (matched for age and gender) were investigated as a control group. Group 2: Twenty-five diagnosed cirrhotic patients without portal hypertension. Group 3: Twenty-five diagnosed cirrhotic patients with portal hypertension. The result of the present study was statistically analyzed, summarized and presented in tables.

Conclusion: It may be concluded that soluble fibrin monomer complex could represent a useful marker ‎for early detection of thrombus generation in chronic HCV cirrhotic patients. It may enable ‎us to pick up vulnerable patients in early stages to start early management.

Open Access Original Research Article

Knowledge, Attitude ‎and ‎Practice ‎Towards Reproductive Health among Females Attending Rural Family Medicine Unit in Gharbia Governorate, Egypt

Laila Abd Elaziz Elshafey, Walla M. Shehata, Ali Ali Elsherbiny, Safynaz Elsaid Shalaby

Journal of Advances in Medicine and Medical Research, Page 270-285
DOI: 10.9734/jammr/2021/v33i2231185

Background: Reproductive health is fundamental to people’s health and survival, economic development and the wellbeing of humanity. Absence of knowledge regarding reproductive health means that ‎women can’t make informed and correct ‎choices, with the consequence that they are likely to suffer from sexually ‎transmitted infections and unwanted pregnancies. Our study aimed to assess knowledge, attitude and practice of females attending Meet Hebish Elbaharia Family Medicine Unit in Egypt regarding reproductive health.

Methods: This cross-sectional study was conducted at Meet Hebish Elbaharia Family Medicine Unit. A pre-designed questionnaire sheet was developed and validated to collect data about socio-demographic, knowledge, attitude and practice of females attending for promotive, preventive and curative health services towards reproductive health.

Results: There were significant relationships between studied females’ socio demographic characteristics and their knowledge, attitude and practice towards reproductive health. The majority of the studied females had a poor level of knowledge about reproductive health. The internet was the main source of information about reproductive health among the studied females. The majority of studied females didn't have pre-marital examination with the commonest used family planning method by females was ‎“IUD” followed by contraceptive pills. Stepwise linear regression detected that total score of socio demographic characteristics of females were the significant predictors for imperfect practice of the studied females towards reproductive health.

Conclusion: Knowledge among females about reproductive health was relatively low and the majority of females had a neutral attitude toward reproductive health. Imperfect practice was high among old aged, illiterates and housewives. There were significant relationships between demographic characteries of females and their knowledge, attitude and practice towards reproductive health. In addition, there were significant relationships between knowledge and attitude of females towards reproductive health from one side and their practice from the other side.

Open Access Review Article

Antidoping Concept of Play Clean to Win Clean: Implication of Herbal Supplements uses for Athletes in Competitive Sports

John Dobgima Fonmboh, Estella Achick Tembe Fokunang, Ngono Mballa Rose, Tama Wango, Richard Aba Ejoh, Nubia Christian Kaba, Michel Disake, Jeane Yonkeu Ngogang, Robert Ndjana, Charles Ntungwen Fokunang

Journal of Advances in Medicine and Medical Research, Page 39-58
DOI: 10.9734/jammr/2021/v33i2231158

The popularity of doping in competitive sports is relevant for all those involved in sports, particularly for evaluating anti-doping policy measures. However, there is a gap of information that addresses this subject so far. As a consequence, the prevalence of doping in competitive sports in resource limited countries is unknown. Even though it is challenging to uncover the exact prevalence of herbal products with prohibited activity such as doping, various methods put in place by world antidoping agency (WADA) have now been adopted to uncover parts of this particular problem, and enables the circumvention to some extend the issues of honesty, definition problems and the limits of pharmacological evidence. It is evident that current doping control test results can show a distinct underestimation of true doping prevalence in low middle income countries (LMIC). Nowadays, doping is a critical issue at international levels of sporting competitions. Athletes’ use of herbal supplements has seen a significant increase in the past two decades. At the top of the list of popular herbs used in sports are echinacea and ginseng, whereas garlic, St. John’s wort, soybean, ephedra and others are also gaining popularity or have been historically prevalent. Despite the increasing popularity of herbal supplements, recent events have illustrated possible concerns regarding efficacy and safety of herbal supplements usage. Remarkable sports performances at the end of the 20th century raised suspicions about herbal supplement use by athletes, prompting the formation of WADA. With WADA creation it was not long when the deaths of two professional athletes raised concerns that the herbal supplement ephedra, may have contributed to their deaths. These events and others have prompted clinicians and scientists to reexamine and evaluate the role of herbal supplements in competitive sports. This review attempts to give an insight into the use of herbal supplement in doping within the concept of play clean to win clean. An attempt has been made to provide guidance on the efficacy and side effect of most used herbal supplements found in sporting activities, especially in international competitive sports.

Open Access Review Article

Persistent Gustatory Dysfunction in COVID-19 Survivors: A Narrative Literature Review

Hironori Tsuchiya

Journal of Advances in Medicine and Medical Research, Page 94-119
DOI: 10.9734/jammr/2021/v33i2231162

Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibit a diverse spectrum of clinical manifestations, some of which last for a long time, making a great impact on the healthcare of patients who recovered from coronavirus disease 2019 (COVID-19). Although taste disorders have been well-recognized to be closely associated with COVID-19, understanding of gustatory sequelae is relatively poor compared with oral symptoms in the early phase of COVID-19. The aim of this study was to characterize gustatory dysfunction in COVID-19 survivors by a narrative literature review of follow-up studies and to speculate the pathogenic mechanisms underlying such a persistent symptom. Scientific articles were retrieved by searching PubMed, LitCovid, ProQuest, medRxiv and bioRxiv from 1 April 2020 with a cut-off date of 10 September 2021. The follow-up time periods of the relevant 49 studies ranged from 4 weeks to 12 months. Results of the literature search indicated that ageusia, hypogeusia and/or dysgeusia persist in up to 45.0% of COVID-19 survivors and that the prevalence of these taste impairments varies depending on ethnicity, age, gender and disease severity of patients. Gustatory dysfunction can be detected at high frequency even one year after symptom onset. Persistence of gustatory dysfunction is pathogenically related to expression of SARS-CoV-2 cellular entry-relevant receptors in taste cells and neural cells, decreased saliva secretion, zinc deficiency, disturbed nervous system and inflammation associated with persistent SARS-CoV-2 infection. Given the long-term persistence of gustatory dysfunction in COVID-19 survivors, their discharge from hospital is not the end of disease. Careful attention should be continuously paid to taste perception of post-COVID-19 patients to recover the health-relating quality of life, which is required for health providers, especially dental professionals who not only may experience COVID-19 survivors but also can easily become aware of their taste abnormalities.