1st Month Research Articles

[Comparison of surgical outcomes between Kahook Dual Blade goniotomy and Trabectome surgery in patients with open-angle glaucoma].

Objective: To compare the medium-term therapeutic effects of Kahook Dual Blade (KDB) goniotomy and Trabectome surgery in the treatment of patients with primary open-angle glaucoma (POAG). Methods: This study was a non-randomized prospective interventional controlled clinical study. POAG patients who underwent KDB goniotomy or Trabectome surgery at Beijing Tongren Hospital from May 2017 to April 2022 were enrolled. The definition of successful surgery was postoperative average intraocular pressure (IOP)≤21 mmHg (1 mmHg=0.133 kPa) and IOP decrease≥20%. Follow-up visits were conducted on the 1st day, 1st week, 1st, 3rd and 6th month after surgery. The IOP value, the number of IOP-lowering medications, the proportion of surgical success (average IOP≤21 mmHg at 6 months), and complications were evaluated. Statistical methods included independent sample t-test, Mann-Whitney rank sum test, χ2 test, repeated measures two-factor analysis of variance, Bonferroni, Friedman M test, Wilcoxon, and Log-rank. The Kaplan-Meier method was used to calculate the cumulative success rate of each group. Results: Seventeen male patients (17 eyes) and 10 female patients (10 eyes) were included. The mean age was (39.9±17.7) years old. There were 11 patients in the KDB group and 16 patients in the Trabectome group. There was no significant difference in clinical baseline conditions between the two groups (P>0.05). The IOPs in the KDB and Trabectome groups at postoperative 1 week [(16.6±6.3) and (16.4±4.1) mmHg) and 6 months [(17.8±5.3) and (19.9±4.4) mmHg) were lower than those before surgery [(25.1±9.3) and (27.4±9.1) mmHg) (all P<0.05). There was no significant difference in the overall IOP between groups (P>0.05). The IOP reduction rates in the KDB and Trabectome groups were 23.4% and 19.0%, with no significant difference (P=0.674). The numbers of IOP-lowering medications used in the KDB and Trabectome groups at 3 months [2.0 (1.0, 4.0) and 2.0 (1.0, 2.3)] and 6 months [2.0 (0.0, 4.0) and 2.0 (1.0, 3.0)] after surgery were not significantly different from those before surgery [4.0 (2.0, 4.0) and 3.0 (2.0, 4.0)] (both P>0.05). There was no statistical significance in the overall number of IOP-lowering medications used between the two groups (P>0.05). There was also no statistically significant difference in the proportion of patients with an IOP decrease of≥20% and the proportion of patients whose mean postoperative IOP was≤21 mmHg (all P>0.05). The proportions of IOP≤21 mmHg in the KDB group and the Trabectome group at 6 months after surgery were 81.8% and 68.8% (P>0.05). Serious intraoperative or postoperative complications occurred in neither group. Conclusions: Both KDB trabeculotomy and Trabectome surgery can effectively reduce IOP and have a good safety profile in treating POAG, with the same number of IOP-lowering medications.

Frequency of lyme disease in patients with tick contact and identification of ticks from Bolu province of Turkey.

Lyme disease is a multisystemic disease caused by the bacteria in the Borrelia burgdorferi sensu lato complex, which is transmitted by ticks of Ixodes genus. Although there are seroprevalence studies and case reports of Lyme disease from various regions in Turkey, there is no widespread epidemiological research. This study aimed to determine the frequency of Lyme disease in the cases followed-up after tick contact and to examine the isolated ticks to reveal tick population from Bolu province. The cases who applied to the emergency department due to tick contact between April and September 2020 were firstly evaluated in our infectious diseases and clinical microbiology outpatient clinic on the third day of exposure and antibodies against Lyme disease were investigated with IFA method to exclude the patients who were previously exposed to B. burgdrorferi. Thereafter, patients were requested to continue outpatient visits at the 1st and 3rd month control. At these controls serum samples were taken to study B. burgdorferi antibodies with ELISA method which was stored at -20°C until the study day. Out of 123 patients who came to first control, 69 patients continued later to at least one of the two controls (either at first or third month). Of these 69 patients, only one (1.4%) was diagnosed with Lyme borreliosis according to clinical and laboratory features. Erythema migrans did not occur in any of the cases. Serum samples were assessed by ELISA method. Asymptomatic infection was detected in 22 cases (30.5%). In addition, we could obtain 46 ticks from our cases and two genera were identified. Forty-two (91.3%) were Ixodes spp, and two (4.3%) were Hyalomma spp. In this study, which was carried out for the first time in the province of Bolu, it was concluded that the cases presenting with a history of tick contact were most frequently exposed to Ixodes spp ticks and the probability of developing Lyme borreliosis was low (1.4%) during the three-month follow-up. Further studies with a greater number of cases and more extended follow-up period are needed.

Speech services by speech volunteers for children with cleft lip and palate in professional lacking area: Pilot study

Background: Cleft lip and cleft palate are the most common birth defects. Children with cleft lip with or without cleft palate (CP±L) face a vary of challenges, depending on the type and severity of the cleft including speech difficulty, dental problems, feeding difficulty, ear infections and hearing loss. Articulation error is the most common residual defect in children with cleft palate with or without cleft lip. Objective: To compare the numbers of pre- and post- articulation errors after using the Model of Speech Therapy by Volunteers (STV) for children with CP±L. Materials and methods: 9 children, aged range 6; 4-14; 2 years old, were included in this study and completely participated in the study. Pre- and post-articulation tests by Myanmar Articulation, Resonation, Nasal Emission and Nasal Turbulence Test were assessed at Mahamuni Monastery, and Thiriyadana Guha Pone Htoon Shan Monastery, Tachileik, Myanmar. STV is composed of a 3-day speech camp (1st month), 3 times 1-day site visits for complicated cases (2nd, 6th, and 10th months) and 3 times of 1-day follow-up speech camps (4th, 8th, and 12th months), Phonological approaches, traditional strategies, and specific techniques for speech correction in children with CP±L were taught to speech volunteers (SVs) and caregivers. Homework was assigned to SVs and caregivers. SVs provided a session of 45-minute speech correction every week. Caregivers practiced 5 sessions of 30 minutes in speech exercises /weeks at home. Results: STV revealed significant reductions in the numbers of articulation errors including articulation screening test [median difference: MD=6 (95% confident interval: CI=5.2-9.2)], and Myanmar articulation standard test at both word and sentence levels; [MD=8 (95% CI=6.5-10.8) and MD=5 (95% CI=4.2-8.3), respectively]. Conclusion: STV significantly decreased a number of articulation errors in children with CP±L of Myanmar, a professional lacking area, and could be applied in any area that has a similar situation. The result was a primary study, the further research should enroll more participants for generalization.

Abstract PO2-10-11: Impact of COVID-19 Pandemic on the Disease Volume, Severity and Clinical Complications at Diagnosis and During First Year of Advanced Breast Cancer: COVID19-ABC Quasi-Experimental Study

Abstract Background: The COVID-19 pandemic affected healthcare systems, tumbling cancer screening programs and increasing fear of infection among medical facilities users. We hypothesized that the pandemic negatively impacted the clinical outcomes of patients (pts) with advanced breast cancer (ABC). The COVID19-ABC study aims to assess the influence of the pandemic on disease volume, severity, and clinical complications at diagnosis and during 1st year of ABC. Methods: Single-center, retrospective, quasi-experimental study with historical control. We included women treated for unresectable/metastatic recurrent or stage IV de novo ABC in a Belgian cancer center. Pts were eligible if ABC was diagnosed between 1/Jun/2020-30/Nov/2021 - pandemic exposure (Exp) cohort - or between 1/Jun/2017-30/Nov/2018 - historical (Hist) cohort. We collected data from medical records for baseline characteristics and study outcomes: proportion of oligometastatic disease (OMD) at ABC diagnosis, and proportion of visceral crisis and disease-related serious clinical events during the 1st month and between 1-12 months after ABC diagnosis. We compared baseline variables between the two cohorts using χ2 test for frequencies and Wilcoxon rank-sum test for continuous variables. We performed a pre-planned subgroup analysis by year of pandemic, immunohistochemistry (IHC) subtype, and recurrent vs de novo ABC. Univariate and multivariate backward stepwise logistic regressions were used to determine the odds ratio (OR) and the 95% confidence interval (CI) of the association of exposure to the pandemic with study outcomes, controlling for confounders. Results: We included 150 pts, 74 in Exp and 76 in Hist cohort. Age and proportion of de novo ABC and triple-negative breast cancer (TNBC) were numerically higher, while comorbidities and Ki67 index were significantly higher among patients in the Exp cohort (Table 1). Pts in the Exp cohort had a significantly higher risk of visceral crisis during the 1st month of ABC (28.4% vs 15.8%; OR 4.24, 95% CI, 1.45-12.39, adjusted for histology grade and recurrent vs de novo), with similar trend between 1-12 months of ABC (19.4% vs 12.7%, OR 1.66, 95% CI, 0.67-4.13). Visceral crisis tended to be more common in patients diagnosed in the 2nd vs 1st year of the pandemic (35.7% vs 26.7%, p=0.50). We observed higher proportions of visceral crisis in the Exp cohort for pts with recurrent ABC (36.5% vs 17.7%, p=0.02), HER2+ (66.7% vs 10.0%, p=0.01), and TNBC (40.0% vs 18.2%, p=0.21) IHC subtypes. The most common indicators of visceral crisis in the Exp cohort were symptomatic brain metastases (33.3%), malignant hypercalcemia (28.6%), and liver metastases with hepatic tests abnormalities (23.8%). OMD at presentation (35.1% vs 36.8%, p=0.83) and disease-related serious clinical events during 1st month (31.1% vs 37.3%, p=0.42) and between 1-12 months (31.9% vs 34.2%, p=0.77) did not differ between cohorts. Conclusion: Our study reports a more clinically severe presentation of ABC during the pandemic compared to historical control. This emerged particularly in recurrences and in more aggressive disease subtypes such as HER2+ and TNBC, suggesting a later diagnosis of ABC during the pandemic. These findings require validation in a larger sample, and longer follow-up is needed to assess survival impact. Table 1. Baseline clinicopathologic characteristics at diagnosis of advanced breast cancer (missing values: 1 for menopausal status, 21 for grade). Citation Format: Diogo Martins-Branco, Véronique Debien, Michel Moreau, Giovanna Pinna, Ottavia Amato, François Cherifi, Guilherme Nader-Marta, Marianne Paesmans, Evandro de Azambuja. Impact of COVID-19 Pandemic on the Disease Volume, Severity and Clinical Complications at Diagnosis and During First Year of Advanced Breast Cancer: COVID19-ABC Quasi-Experimental Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-10-11.

Effect of postpartum depression and role of infant feeding practices on relative weight of child at 1 and 3 years of age

BackgroundChildhood obesity has increased and is considered one of the most serious public health challenges of the 21st century globally, and may be exacerbated by postpartum depression (PPD). The purpose of this study was to examine the association between PPD at 1st and 6th month postpartum, infant feeding practices, and body mass index (BMI) z-score of the child at one and three years of age.MethodsThis study used data from an ongoing prospective maternal-child birth cohort performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan with the period of recruitment from May 13, 2010 to November 28, 2013. Out of 2,309 total number of mothers, 1,279 mother–child dyads were assessed in the study. We performed multivariable linear regression analysis to examine the association between PPD and child’s BMI z-score stratified by the child’s age at 1 year and 3 years of age.ResultsThe prevalence of PPD at 1 month postpartum (17%) was found to be higher than at 6 months (12%). In multivariable linear regression analysis we observed that children at 3 years who had mothers with PPD at 6 months had, on average, a BMI z-score 0.25 higher than children of mothers who did not have PPD at 6 months (ß coefficient 0.25, 95% CI [0.04 to 0.46], p value 0.02), holding all other covariates constant. Also, initiation of weaning food when child is at six months of age was associated with higher BMI z-score of the child at 3 years after adjusting for all covariates (ß coefficient = 0.18, 95% CI [0.03 to 0.34], p-value < 0.05).ConclusionThe significant association between PPD at 6 months and child’s BMI z-score at 3 years of age, in conjunction with birth trends and high prevalence of PPD, can add to the body of evidence that there is need for multiple assessment across the first postpartum year to rule out PPD as early screening and early interventions may benefit both maternal health and child development outcomes. These findings can indicate the need for establishing support systems for care-giving activities for mothers with PPD.

A Prospective Cross-Sectional Study on the Vitamin D Status of Neonates and the Impact of Neonates’ Standard Vitamin D Supplementation on Neonatal Morbidities

(1) Background: This study aimed to determine whether standard-dose vitamin D supplementation could provide adequate levels in exclusively breastfed infants born with different cord 25(OH)D levels and to evaluate related neonatal morbidities. (2) Methods: A prospective cross-sectional study was designed in term infants. Three groups were formed based on cord 25(OH)D levels; Group1 Deficiency:25(OH)D &lt; 12 ng/mL, Group2 Insufficiency:25(OH)D = 12–19 ng/mL, and Group3 Optimum:25(OH)D = 20–100 ng/mL. Cord and 1st month 25(OH)D levels, after receiving standard-dose vitamin D prophylaxis, neonatal outcomes and anthropometric measurements were compared. (3) Results: The study involved 86 infants. Group1 Deficiency had also significantly lower 25(OH)D levels at 1st month compared to the others (p &lt; 0.001). There was a significant positive correlation between cord and 1st month 25(OH)D levels (r = 0.78, p &lt; 0.001). Despite the fact that the mother’s age and clothing style were similar, Group1 Deficiency mothers had higher parity numbers and used less vitamin D during pregnancy (p = 0.03, p = 0.04). Neonatal outcomes analysis revealed that newborns in Group1 Deficiency experienced more respiratory distress, transient tachypnea, and early-onset sepsis, as well as more and longer hospital stays in the first-month of life (p &lt; 0.05). (4) Conclusions: Infants with low cord 25(OH)D levels had also lower 25(OH)D values in the 1st month of life and experienced higher rates of neonatal morbidities. Given its numerous biological activities and impact on neonatal morbidities, determining an individualized dose of vitamin D supplementation may be more accurate than using the standard approach.

Вибір блокатора ренін-ангіотензин-альдостеронової системи для лікування серцевої недостатності при гострому міокардиті

The aim – to evaluate the effectiveness of sacubitril/valsartan and enalapril in heart failure treatment in patients with acute severe myocarditis with reduced left ventricular ejection fraction based on dynamic analysis of the heart structural and functional changes.Materials and methods. The study is based on the results of examinations of 90 patients with a severe course of acute myocarditis (AM) with reduced ejection fraction (EF) of the left ventricle (LV) – ≤40 %. The patients were divided into two groups: the 1st group included 48 patients who were treated with an angiotensin-converting enzyme (ACE) inhibitor – enalapril as part of heart failure (HF) therapy; the 2nd group included 42 patients with AM who received the sacubitril/valsartan combination instead of enalapril in the complex therapy of HF. All patients underwent a 6-minute walk test, echocardiography (EchoCG) with the speckle-tracking method, and cardiac magnetic resonance imaging (CMR). Examinations were carried out three times: in the 1st month from the onset of AM symptoms before the appointment of drug therapy, after 6 and 12 months of observation. Part of the patients from the 1st group, namely 25 patients (52.1 %) in whom the use of ACE inhibitors proved to be ineffective after six months, was transferred to the combination of sacubitril/valsartan (group 1A).Results and discussion. After six months of treatment, compared to the 1st group, the patients of the 2nd group were distinguished by better indicators of the structural and functional state of the heart, which characterise the contractility and volume of the LV – the values of LV EF and LV longitudinal global systolic strain (LGSS) were higher by 13,7 and 26.2 % respectively, LV end-diastolic volume index (EDVi) was 13.2% lower, as well as a 21.7 % lower number of LV segments in which delayed contrast was detected on cardiac MRI. After six months of taking the sacubitril/valsartan combination in 1A group patients, an improvement in the structural and functional state of the heart was also achieved: the values of LVEF and LGSS increased by 19.2 % and 27.9 %, respectively, and LV EDVi decreased by 19.0 %; the number of LV segments in which delayed enhancement was determined on cardiac MRI decreased by 30.7 %. With the help of regression analysis, it was established the presence of a set of factors that determine the priority of prescribing the sacubitril/valsartan combination as initial therapy in patients with severe myocarditis: presence of reduced LVEF – ≤40 %; pronounced decrease in longitudinal and circular global LV strain – ≤8.5 and ≤9.0 %, respectively; pronounced dilatation of the LV – EDVi ≥102 ml/m2; presence of III or higher HF functional class; presence of delayed enhancement in ≥ 5,0 LV segments according to cardiac MRI data.Conclusions. In patients with a severe course of myocarditis, the sacubitril/valsartan combination prescribed as initial therapy showed higher effectiveness compared to ACE inhibitors in terms of improving contractility and reducing LV dilatation, as well as improving the functional class of heart failure. A complex of factors has been established that prove the expediency of prescribing the sacubitril/valsartan combination as initial therapy for heart failure in patients with acute myocarditis.

Beyond the aesthetic purposes of the botilinum toxin A; The dry eye syndrome with essential blepharospasm

Botulinum A toxin injection is a method used in clinical conditions such as blepharospasm, hemifacial spasm, strabismus, migraine, hyperhidrosis, torticollis and migraine, in addition to its use for cosmetic purposes. It works by reducing the release of acetylcholine at the neuromuscular junction, and as a result, a type of paralysis occurs in the applied area for a while. Botox applied around the tear collection ducts can provide dual benefits by reducing tear loss and relieving blepharospasm. In this study, botulinum toxin A injection was applied to 33 patients with essential blepharospasm and also dry eye syndrome. Schirmer test measurement, tear breakup time (BUT) and rose bengal disappearance test were measured before the injection and at the 1st week, 1st month and 3rd month after the injection. At the same time, sampling was performed for impression cytology before the injection and at the 1st and 3rd months after the injection. Symptoms and signs of blepharospasm decreased in all patients treated with botulinum toxin A. However, the patients' Schirmer test measurements were measured immediately one week after the injection and decreased in other measurements. Tear breakout time (BUT) increased in the 1st week after the injection but decreased in the 4th week measurements. Rose bengal disappearance score increased in the 1st week after injection and returned to its previous state in the 4th week. As a result of impression cytology, no change in conjunctival cell morphology was observed before and after injection. In conclusion, essential blepharospasm and dry eye are two independent diseases, but they can occur simultaneously. Botulinum toxin A injection is a very effective method in the treatment of blepharospasm. Although it has been stated in different studies that it has a positive effect on dry eye syndrome, it was observed that it did not have such an effect in our study.

The Effect of Commercial Essential Oil Mixture Applied to Neonatal Simmental Calves on Growth, Development and Health Parameters

In this study, the effectiveness of commercial essential oil mixture application in preventing calf losses due to diarrhea and on the growth, development and health parameters of calves was investigated. For this purpose, 24 newborn Simmental calves were used. Following birth, 20 ml of essential oil mixture was given orally via syringe to the calves in the treatment group after drinking milk in the morning for 5 days. The average birth weight of calves was 39.0 ± 0.72 kg. Birth weight of male and female calves were 42.3 ± 1.01 and 38.6 ± 0.96 kg respectively, the difference between groups were found significant. First month weight was 45.7 ± 1.67, 42.4 ± 1.65 kg in the control and treatment groups, respectively. There was no difference between the control and treatment groups in terms of body measurements taken at birth, but a significant difference was observed in chest circumference in favor of the control group in terms of measurements obtained at the 1st month. There was no difference between the treatment and control groups in terms of hematological parameters detected in the blood taken on the 10th day and in the 1-month period. No differences were observed between groups in terms of immunoglobulin levels (IgM and IgG). There was no effect of the commercial essential oil mixture on the fecal score of the calves included in the trial. It was revealed that the essential oil mixture does not make any difference in the growth, development and health of Simmental calves in a one-month period. In future studies on the subject, it is recommended that higher doses of the essential oil mixture be investigated.

Long‐term quality of life after open and laparoscopic total gastrectomy for stage I gastric cancer: A prospective multi‐institutional study (CCOG1504)

AbstractBackgroundLittle information is available from prospective clinical trials on the influences of surgical approaches on postoperative quality of life (QOL). We aimed to prospectively compare chronological changes in postoperative body weight and QOL between laparoscopic and open total gastrectomy for stage I gastric cancer (GC).MethodsWe conducted a multi‐institutional prospective study (CCOG1504) of patients who undergo laparoscopic or open total gastrectomy. Body weight was measured at the baseline and at the 1st, 2nd, and 3rd postoperative years (POY). QOL using the European Organization for Research and Treatment of Cancer quality of life questionnaire‐C30 (EORTC QLQ‐C30) and the Post‐Gastrectomy Syndrome Assessment Scale‐37 (PGSAS‐37) questionnaires were measured at the baseline and at the 1st, 3rd, 6th, 12th, and 36th postoperative months (POM).ResultsWe enrolled 84 patients from 15 institutions, and finally 43 patients for the laparoscopic group and 16 for the open group were eligible for data analysis. There were no significant differences in body weight change between the two groups. The role functioning score among the EORTC QLQ‐C30 tended to be higher (i.e., better QOL) in the laparoscopic group at POM 1 and 12 after surgery compared to the open group. The dissatisfaction at working score among the PGSAS‐37 at 1 month after surgery was lower (i.e. better QOL) in the laparoscopic group compared to the open group.ConclusionsThe results of CCOG1504 indicated that laparoscopic approach for total gastrectomy was associated with a more favorable dissatisfaction at working score (PGSAS‐37).

Quantification of anterior translation of tibia over femur using Lachmeter in anterior cruciate ligament reconstruction with hamstring tendon autograft

Background: The anterior cruciate ligament (ACL) is an important restraint on anterior tibial translation of the knee. Arthroscopic ACL reconstruction using hamstring tendon autograft is the most widely accepted surgical procedure for ACL insufficiency. This study is assessing the effect of ACL reconstruction by hamstring tendon autograft on the anteroposterior stability of the knee joint by measuring the side-to-side difference of anterior tibial translation using the Lachmeter. We are also assessing the functional outcome of the same surgery using international knee documentation committee (IKDC) score. Methods: The study included 30 patients who were admitted for ACL reconstruction with hamstring tendon autograft. The side-to-side difference of anterior tibial translation was assessed by using Lachmeter preoperatively and postoperatively at the end of the 1st, 3rd, and 6th months. The IKDC score was assessed preoperatively and postoperatively at the end of 6th month. Results: The mean Lachmeter value of respondents in the current study was 4.31±0.56 mm during the preoperative period. Lachmeter values were 2.79±0.42 mm, 2.09±0.42 mm, and 1.29±0.39 mm, respectively, at the end of the first, third, and sixth months postoperatively. Mean preoperative and postoperative 6th month IKDC scores were 55.83±7.7 and 89.20±5.3 respectively. Conclusions: There is significant serial improvement in the side-to-side difference of anterior tibial translation in the 6 months of post operative period following ACL reconstruction using hamstring tendon autograft. The improved IKDC score from preoperative to postoperative level is also indicating a positive functional outcome.

A comparative study of the use of digital technology in the anterior smile experience

Objectivesthis study aims to compare the clinical outcomes of traditional and digital crown extension guides in the aesthetic restoration of anterior teeth. Additionally, the study will analyze the differences in the results of various digital crown extension guides in anterior aesthetic restorations.MethodsSixty-two patients who required aesthetic restoration of their anterior teeth were selected for this study. The patients had a total of 230 anterior teeth and were randomly divided into three groups: a control group of 22 cases who received diagnostic wax-up with pressure film, an experimental group 1 of 20 cases who received 3D printed digital models with pressure film, and an experimental group 2 of 20 patients who received digital dual-positioning guides. The control group had a total of 84 anterior teeth, experimental group 1 had 72 anterior teeth, and experimental group 2 had 74 anterior teeth. The study compared three methods for fabricating crown extension guides: the control group used the diagnostic wax-up plus compression film method, while experimental group 1 used compression film on 3D printed models and experimental group 2 used 3D printed digital dual-positioning crown extension guides. After the crown lengthening surgery, the control group patients wore DMG resin temporary crown material for gingival contouring, while the experimental group patients wore 3D printed resin temporary crowns for the same purpose. The patients were followed up in the outpatient clinic after wearing temporary crowns for 1 month, 3 months, and 6 months, respectively. The clinical results were evaluated in terms of marginal fit, red aesthetic index, and white aesthetic index.ResultsBased on the statistical analysis, the experimental group required significantly fewer follow-up visits and less time for guide design and fabrication compared to the control group. Additionally, the surgical time for the experimental group was significantly shorter than that of the control group. During the postoperative period between the 1st and 3rd month, the PES index scores for the marginal gingival level, proximal, and distal mesiodistal gingival papillae of the experimental group showed a trend of superiority over those of the control group. By the 6th month, the marginal gingival level exhibited a significant difference between the experimental and control groups. The experimental group demonstrated superior results to the control group in terms of shape, contour, and volume of the teeth, color, surface texture, and transparency of the restorations, and features during the 1st and 3rd postoperative months. In the 6th month, the comparative results indicated that the experimental group continued to exhibit superior outcomes to the control group in terms of the shape, color, surface texture, and transparency of the restorations, as well as the characteristics of the teeth. Additionally, the experimental group demonstrated significantly fewer gingival alterations than the control group at 1 month, 3 months, and 6 months post-procedure, with this difference being statistically significant. Furthermore, the combination of 3D printing technology and restorative techniques was utilized, resulting in consistent patient satisfaction.ConclusionDigitalisation plays an important role in anterior aesthetic restorations. The use of digital technology to manage the entire process of anterior cosmetic restorations can improve restorative results, reduce the number of follow-up appointments, shorten consultation time, and achieve better patient satisfaction.

EVALUATION OF RECOVERY BY STAPES REFLEX IN PATIENTS WITH PERIPHERAL FACIAL PARALYSIS

Objective: The aim of this study was to investigate the acoustic reflex in different frequencies at the time of diagnosis, during the treatment and follow-up of patients with idiopathic peripheral facial nerve palsy and compare these results with House-Brackmann clinical scoring to determine the prognostic value of acoustic reflex in these patients. Material and Methods: Thirty-three adult patients with idiopathic peripheral facial palsy (aged 18-77 years, 16 male, 17 female) were included in the study. All the patients were clinically graded with House-Brackmann clinical scoring and acoustic reflex test was performed at the time of diagnosis, 1st, 2nd, 3rd, 4th weeks, 2nd and 3rd month. Ipsilateral acoustic reflex thresholds were measured from both ears with impedance audiometry using a 226 Hz probe tone. Results: Significant relation was observed between the presence of sequel and initial grade and absence of acoustic reflex at 0.5, 1, 2 kHz at time of diagnosis. In addition, after the 1st week, a significant relation was also detected at 4 kHz frequency during all the follow-up period. The risk of sequelae would increase more than 3 times as the initial grade value increased. Conclusion: The present study revealed the relation between the sequel and initial high grade, the absence of acoustic reflex at 0.5, 1, 2 kHz at time of diagnosis in addition with high age. Statistics does not support the same relation at 4 kHz frequency at time of diagnosis. However, statistic reveals that only the initial grade can best predict the risk of sequel, in addition, the risk of sequel increases more than 3 times as the initial grade value increase.

The effect of birth memory, recall level, and related factors on breastfeeding attitude of mothers in the postpartum period: a prospective study

AbstractThis study was conducted to examine the effect of birth memory, recall level, and related factors on postpartum mothers’ breastfeeding attitudes. This is a correlational prospective study. The study was conducted in the postpartum clinic of a city hospital in a province located in the Central Anatolia Region of Turkey. The study included a total of 248 mothers in the early postpartum period. Data were obtained via a Personal Information Form, a Labor Monitoring Form, the Birth Memories and Recall Questionnaire (BirthMARQ), the Birth Satisfaction Scale (BSS), and the Iowa Infant Feeding Attitude Scale (IOWA). A positive correlation was found between mothers’ level of birth memory and recall and breastfeeding attitude on postpartum day 1, month 1, and month 3. In the regression analysis, emotional memory and coherence and reliving, which are the sub-dimensions of the birth memory and recall scale affecting breastfeeding attitude, were found to be significant associated risk factors for the 1st postpartum day, consistency and reliving for the 1st month, and birth memory and recall for the 3rd month. No relationship was found between mothers’ breastfeeding attitude and birth satisfaction on postpartum day 1, month 1, and month 3. Positive birth memory and recall positively affected mothers’ breastfeeding attitude. No relationship was found between mothers’ labor satisfaction and breastfeeding attitude. Supporting women for the formation of positive birth memory and recall for the labor process may positively improve breastfeeding attitudes of mothers in the postpartum period.

Evaluation of isotretinoin effects on depression, sleep apnea and sleep quality

Background Isotretinoin is used to treat severe acne, treatment-resistant moderate acne, and acne that leads to scarring or psychological distress. It has many side effects and is also associated with depression, sleep apnea, and sleep disturbances. Objectives In this study, we aimed to evaluate the effects of isotretinoin on depression, sleep apnea, and sleep quality. Methods A total of 42 patients diagnosed with acne and started isotretinoin treatment were included in the study. In order to compare the effects of isotretinoin, patients were asked to fill out a questionnaire containing the Beck Depression Inventory (BDI), the Berlin Questionnaire (BQ), and the Pittsburg Sleep Quality Index (PSQI) at baseline and third months of treatment. Results There was no statistically significant difference in BDI, BQ, and PSQI scores between the 1st and 3rd months of treatment (p = .53, p = .5, p = .35). Conclusion This study showed that isotretinoin had no significant effects on depression and sleep quality.

Macular hole surgery follow-up with spectral domain-optical coherence tomography-guided facedown posturing.

The main treatment for macular hole (MH) is pars plana vitrectomy, with or without internal limiting membrane (ILM) peeling, followed by gas tamponade and face-down positioning (FDP). This study aims to present the anatomical and visual outcomes following MH repair with optical coherence tomography (OCT)-guided FDP. Thirty-two patients who underwent surgery for idiopathic MH were enrolled. The requirement for the prone position was lifted for those with MH closure observed under gas on postoperative day one OCT. Patients with unclosed MHs were instructed to maintain FDP until the 3rd day. Best-corrected visual acuity at preoperative, postoperative 1st month, and the last visit, closure time post-surgery, duration of prone position, and surgical success rate were recorded. Among the patients, 21 underwent phacovitrectomy + ILM peeling + gas tamponade, while 11 had vitrectomy + ILM peeling + gas tamponade. On postoperative day one, 28 out of 32 MHs closed, with 3 closures on day 3 and one on day 5. There were 18 stage two (56.3%), 13 stage three (40.6%) and 1 stage four (3.1%) MHs. The mean minimum MH diameter was 381.75 ± 68.07 (min 260-max 517) microns. All patients with MH closure time over postoperative day one had non-combined vitrectomy instead of phacovitrectomy. No late complications were observed. OCT-guided FDP approach yields excellent closure rates with no late complications and ensures good patient comfort.

Funding Pattern Comparison Pre- and Post-Ayushman Bharat National Health Scheme (AB-PMJAY) in Active Females Undergoing TKA for Advanced Knee Arthritis with Clinical, QoL Analysis and AB-PMJAY Technical Data.

Patients visiting for Knee Arthroplasty have often been treated at neighborhood clinics and bonesetters. India floated world's largest publicly funded national health insurance program -AB-PMJAY covering Knee Arthroplasty. AB-PMJAY's data for Arthroplasty has not been published. A Prospective study from Jan 2016- Jan 2023 on females undergoing TKA. Age, DEXA Score, Walking Ability, KSS, 10MWT, SF36 Scores, Funding Pattern before and after AB-PMJAY, Time to Approval, Time to discharge, Time to Query reply and Rejection Rates were documented. 790 patients (91.86%) received treatment previously. 650 (78.54%) patients lived with family & 32 patients lost to follow-up. 37.67% & 62.32% patients had Grade. 3 & 4 osteoarthritis respectively. Commonest comorbidity was Vitamin D deficiency followed by Menopause and Hypertension. Post-treatment Vitamin D deficiency reduced from 68.59% to 2.17% at 3 months. Post-surgery, Functional Scores improved significantly at 1st and 6th month. VAS dropped significantly from 7.8 to 3.6 at 1st month follow up. At 6 months, 81.52% patients were independent outdoor walkers compared to 9.42% (baseline). Average hospital stay-54 hours and Return to work- 42 days. Central health scheme beneficiaries rose significantly from 12% (pre-PMJAY) to 42% (post-PMJAY). With AB-PMJAY, no rejection for surgical procedures, Time to surgery approval was 16 hours (mean) and Time to Discharge was 8 hours (mean). Time to reply was 6 hours (mean). Evident rise in patients getting TKA done through AB-PMJAY. TKA has become an affordable and achievable target for financially deprived patients, post regulation of knee implant prices & AB-PMJAY.

A DIRECT BONDING TECHNIQUE VERSUS AN INDIRECT BONDING TECHNIQUE - AN IN VIVO ANALYSIS

Objectives: The objectives of this study were to compare the clinical performance of an indirect versus a direct bonding technique in a split mouth study design and to develop a reproducible and cost efficient technique for indirect bonding for clinical use. Methods: This comparative study was conducted on Twelve patients (212 teeth; 106 each in direct and indirect group) who reported to the Department of Dentistry at Ruxmaniben deepchand gardi medical college, Ujjain, Madhya Pradesh. Transbond XT (3M Unitek) adhesive and primer were used to bond the brackets onto the teeth in both the direct and indirect bonding groups using split mouth study design. Transfer trays constructed using Thermal glue matrix applied through hot glue gun for indirect bonding. The clinical performance was assessed for 6 months. Results: In the 1st month was a failure of one lower 2nd premolar bracket from the indirect bonding group (p=1.00). There on in the subsequent months there were no failures for 6 months. The study showed no statistically significant differences in clinical performance in both group (p=NS). Conclusion: The failure rates for both the indirect and direct bonding techniques in this study were the same. Statistically, there was no significant difference between the two groups. The indirect bonding technique used in this study was found to be an effective and efficient means of bonding orthodontic brackets. Transbond XT and thermal glue matrix found to be suitable choice for use in indirect bonding technique for clinical use.

Evaluation of the results of contact lens assisted corneal cross-linking treatment in keratoconus patients with thin corneas.

We aimed to compare the efficacy and safety of accelerated contact lens-assisted cross-linking (CA-CXL) with Lotrafilcon B and Comfilcon A lenses in keratoconus (KC) patients with thin corneas. Retrospective, single-center study. We retrospectively included 51 eyes of 39 KC patients with corneal thickness <400µm after epithelial scraping (Epi-off), who underwent accelerated CA-CXL treatment with Lotrafilcon B (n=20) and Comfilcon A (n=31). Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest refraction values, corneal topographic data and endothelial cell density were recorded at preoperative and postoperative 1st, 3rd and 6th month controls. CDVA in the Comfilcon A group was higher than CDVA before surgery at 6 months postoperatively (p<0.001). When the two lenses were compared, CDVA was found to be significantly higher in the Lotrafilcon B group in the preoperative, postoperative 1st month and 3rd month values, but there was no significant difference between the postoperative 6th month values (p=0.028, p=0.018, p=0.044, p=0.181, respectively). The maximum keratometry (Kmax) value at the 6th month after surgery in the Comfilcon A group was significantly lower than in the Lotrafilcon B group (p=0,009). There was no significant difference between the endothelial cell density values between the groups (p=0.623, p=0.609, p=0.794, p=0.458, respectively). There was no significant difference between the progression, regression, and stability rates of the two groups (p=0.714). Accelerated CA-CXL with Lotrafilcon B and Comfilcon A silicone hydrogel lenses is a safe and effective method to stop progression in patients with thin corneas.

Investigation of Differences in the Techniques of Experimental Vitreo-retinal Operations on Laboratory Animals

The continuous development of vitreoretinal surgery makes it possible to provide high-tech care to patients with retinal detachment while minimizing intraand postoperative complications. However, their percentage still remains significantly high. This pushes modern ophthalmological science to new research and search for solutions to existing problems. In this task, laboratory animals, on which the latest advances in medicine have been tested for more than 100 years, help like no one else. Unfortunately, the high cost of experiments often repels and/or pushes them back indefinitely. Given the clinical significance of experimental studies of surgical treatment of retinal detachment, as part of the study of the new hydrogel preparation Vitreolon, an analysis was made of methods for removing the vitreous body and their effect on the result of surgical intervention.Purpose: analysis of differences in vitreous removal techniques in laboratory rabbits.Material and methods. The experiment involved 6 rabbits (12 eyes) with induced retinal detachment. In 6 eyes, vitrectomy was performed using a vitreotome, in the others, using a syringe (21G). Subsequently, tamponade of the vitreal cavity was performed with the new hydrogel preparation “Vitreolon”. Ophthalmological examinations were performed on the 1st day, 1st and 2nd week, 1st and 3rd months after surgery. After that, the eyes were enucleated to conduct a morphological study of macropreparations and histological sections of the eyes.Results. According to the results of ophthalmological and laboratory studies, there was no statistically significant difference between the techniques for removing the vitreous body. One rabbit had hypertension and cataracts, which indicates its individual response to surgery. There were no complications that could lead to early termination of the experiment.