End Of Sixth Month Research Articles

Dermatological findings of vitamin B12 deficiency and resolving time of these symptoms

Aim: The mucocutaneous changes observed during vitamin B12 deficiency in children have been published only as case studies and small case series. In this study, we aimed to demonstrate the frequency of mucocutaneous changes (particularly hyperpigmentation) seen during vitamin B12 deficiency and resolving time of these symptoms with vitamin B12 treatment.Material and methods: This prospective study was conducted at the pediatrics outpatient clinic of Harran and Yuzuncu Yil University Faculty of Medicine, among 57 patients, aged between 6 and 24 months, who were diagnosed with vitamin B12 deficiency following various examinations and tests. A detailed examination was performed in respect to skin and mucosal findings. Patients with vitamin B12 deficiency were administered intramuscular cyanocobalamin. Prospective examination was continued, and resolving time of symptoms after treatment was recorded.Results: The mean age of the patients enrolled in the study was found to be 12.75 ± 4.75. Hyperpigmentation was reported in 49 (85.96%) patients enrolled in the study; atrophic glossitis in 40 (70.17%), brittle and matt hair in 13 (22.80%), skin lesions (particularly diaper dermatitis) in eight (15.78%) and cheilosis in four (7.01%) patients. Three months after the treatment initiation, hyperpigmentation improved in 87.75%, atrophic glossitis in 97.5% and brittle and matt hair in 92.3% of the patients. Five patients (8.77%) with continuing pigmentation by the end of sixth months were considered as nonresponsive to the treatment.Conclusion: Deficiency of vitamin B12 should be considered in the differential diagnosis of infants who present with skin and mucosal lesions.

Clinical evaluation of the fiber post and direct composite resin restoration for fixed single crowns on endodontically treated teeth

BackgroundThe restoration of an endodontically treated fractured tooth has been a challenge for restorative dentists for decades. The performance of fiber posts when used in conjunction with direct composite resin restorations have been largely unreported. This study was conducted with the aim of evaluating the survival rate of endodontically treated teeth restored with adhesive bonded fiber reinforced resin posts and direct composite core with additional crown coverage. MethodsSixty patients who required endodontic treatment with post core crown were selected from outpatient department of Air Force Institute of Dental Sciences, Bangalore. Sixty-four teeth were endodontically treated and restored with fiber post and direct resin composite core restoration. Patients were evaluated immediately after restoration and reevaluated at the end of first, second and third months. After 3 months of clinical evaluation, if teeth were asymptomatic they were restored with complete coverage porcelain fused to metal restorations and evaluated immediately, and again reevaluated at the end of first, third, and sixth months. ResultsAfter 3 months of clinical evaluation, only two teeth exhibited periapical lesion with clinical symptoms and three teeth without any clinical symptoms. Five teeth exhibited slight marginal staining, three teeth showed partial loss of restoration, and two teeth exhibited complete loss of restoration with the fracture of the post. At the end of sixth month after restoration with full coverage crown, two teeth had dislodged restoration due to fracture of post and two teeth exhibited displacement of the post. ConclusionFiber posts are the best alternative for restoration of fractured endodontically treated teeth. Fiber posts and direct composite resin core materials are strongly recommended for restoration of endodontically treated mutilated teeth among the dental establishments of Armed Forces.

Parmak replantasyonlarında rehabilitasyon uygulamalarımız ve fonksiyonel sonuçlarımız

Objectives: In this study the results of patients who got our regular rehabilitation program for replantations at and distal to the metacarpophalangeal joint level were evaluated retrospectively. Methods: Sixty thumbs and/or fingers in 48 patients with different level amputations operated between 2000 and 2005 were evaluated. Of the 48 patients, 25 were men and 23 were women. The mean age was 26.31 (range: 6-55) years. The mean follow up time was 16 (range: 6-48) months. The rehabilitation started at forth to eight postoperative week and continued until the end of sixth month. The evaluation were performed assessing the joint range of motions, performance of the related part in daily activities, cosmetic appearance and the satisfaction of the patient according to Tamai criteria. Results: The functional results of 23 patients (% 47.91) were graded perfect, 19 patients (%39.58) were good, 4 patients (%8.33) were average and 2 patients were (%4.16) poor accoring to Tamai criteria. Conclusion: Rehabilitation after finger replantations is tough due to the complex anatomy, but results are satisfying over the long term. Postoperative rehabilitation should start as soon as possible. During this period the surgeon, the patient and the physiotherapist should be in a very intimate collaboration. It is observed that functional result in patients who went good along with the rehabilitation program, splint usage and home practices is better.

The Effect of Biofeedback Therapy on the Residual Urine Volume in Children With Dysfunctional Voiding

Purpose To evaluate the effect of biofeedback therapy on the residual urine volume in children with dysfunctional voiding. Material and Methods This prospective study was conducted in children with dysfunctional voiding associated with abnormal postvoid residual urine (PVR) from June 2002 to 2007. The children were divided randomly into 2 groups. Group 1 was treated with standard urotherapy combined with biofeedback therapy and group 2 was treated with only standard urotherapy. The outcomes of uroflowelectromyography pattern, urinary tract infection (UTI), and PVR were recorded before and at the end of sixth month of treatment. Results A total of 94 patients were enrolled in this study. Groups 1 and 2 consisted of 62 and 32 patients, respectively. The voiding pattern became normal in 80.6% (50/62) and 56.2% (18/32) of patients in groups 1 and 2, respectively. The PVR resolved in 40 of 62 (64.5%) patients in group 1 and in 11 of 32 (34.4%) children in group 2. Before the treatment, UTI was noted in 22.5% of patients (14/62) in group 1 and 21.8% of patients (7/32) in group 2. After the treatment, UTI was observed in 3.2% of patients (2/62) and in 9.3% (3/32) of patients in groups 1 and 2, respectively. Although both treatment modalities changed the voiding pattern, rate of febrile UTI, and PVR positively, these outcomes were better in a combination group. Conclusions The combination of standard urotherapy with the biofeedback therapy improved the results significantly.

Effect of etonogestrel implant on serum lipids, liver function tests and hemoglobin levels

BackgroundThis study aimed to assess the possible effects of etonogestrel implant (Implanon®, Organon, Oss, The Netherlands) on total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and Hb levels in a sample of Turkish population. Study DesignHealthy women of childbearing potential who had applied to our Family Planning Clinic for a contraceptive method and had chosen to have an Implanon insertion after thorough counseling about all family planning methods and screening for eligibility for Implanon use were enrolled in the study. Serum concentrations of TC, TG, HDL-C, LDL-C, AST, ALT and Hb levels were tested before and at 3 and 6 months after insertion. Baseline mean parameters were compared with mean parameters at 3 and 6 months for statistical significance using paired-samples t test. ResultsEighty-two women eligible for the study were included. Mean age of the patients was 27.5±4.8 years. When compared to the baseline values, there was a statistically significant decrease in the TC (p<.001), HDL-C (p<.001) and TG (p=.006) at the end of the third month, while there was a significant increase in Hb values (p=.01). The decrease in TC (p=.001) and HDL-C (p<.001) and increase in Hb value (p=.03) persisted by the end of sixth month while the decrease in TG was transient. A statistically significant increase in mean ALT level was observed at 6 months (p=.03). ConclusionThe effect of Implanon on liver functions and lipid metabolism does not lead to unhealthy alterations. Increase in Hb can be attributed to the high frequency of amenorrhea in patients.

Management of Abnormal Postvoid Residual Urine in Children With Dysfunctional Voiding

To evaluate the effect of biofeedback therapy on the residual urine volume in children with dysfunctional voiding. This prospective study was conducted in children with dysfunctional voiding associated with abnormal postvoid residual urine (PVR) from June 2002 to 2007. The children were divided randomly into 2 groups. Group 1 was treated with standard urotherapy combined with biofeedback therapy and group 2 was treated with only standard urotherapy. The outcomes of uroflow-electromyography pattern, urinary tract infection (UTI), and PVR were recorded before and at the end of sixth month of treatment. A total of 94 patients were enrolled in this study. Groups 1 and 2 consisted of 62 and 32 patients, respectively. The voiding pattern became normal in 80.6% (50/62) and 56.2% (18/32) of patients in groups 1 and 2, respectively. The PVR resolved in 40 of 62 (64.5%) patients in group 1 and in 11 of 32 (34.4%) children in group 2. Before the treatment, UTI was noted in 22.5% of patients (14/62) in group 1 and 21.8% of patients (7/32) in group 2. After the treatment, UTI was observed in 3.2% of patients (2/62) and in 9.3% (3/32) of patients in groups 1 and 2, respectively. Although both treatment modalities changed the voiding pattern, rate of febrile UTI, and PVR positively, these outcomes were better in a combination group. The combination of standard urotherapy with the biofeedback therapy improved the results significantly.

Efficacy of laparoscopic Roux-en-Y gastric bypass in the treatment of morbid obesity complicated with type 2 diabetes mellitus.

Objective To evaluate the efficacy of laparoscopic Roux-en-Y gastric bypass(LRYGB)in the treatment of morbid obesity complicated with type 2 diabetes mellitus,and to discuss the mechanism of LRYGB in the treatment of type 2 diabetes mellitus.Methods The clinical data of 30 type 2 diabetes mellitus patients with body mass index(BMI)≥35.00 who had undergone LRYGB from January 2007 to July 2007 in Cleveland Clinic were prospectively analyzed.The pre-and postoperative clinical parameters wcle analyzed by t test.Results The BMI,fasting plasma glucose and glycosylated hemoglobin were significantly decreased 6 months after the operation(t=27.399,23.025.15.593,P＜0.05).The cure rate at the end ofthe second month was 70%(21/30),and it was increased to 90%at the end of sixth month(27/30).The condition of the remaining 3 patients were improved.At the end of the second and sixth month',ffter operation,the BMIs of the patients who were cured by LRYGB were decreased by 27.89%±5.51%and 45.73%±2.82%.and the BMIs of the patients whose condition was improved were decreased by 35.65%±1.97%and 58.00%±3.05%(t=5.755,7.081,P＜0.05).Conclusions LRYGB is effective in the treatment of morbid obesity complicated with type 2 diabetes mellitus.The curability of morbid obesity increases as the BMI decreases. Key words: Obesity,morbid; Anastomosis,Roux-en-Y; Laparoscopy; Diabetes mellitus,type 2

Role of Power Doppler sonography in evaluation of therapeutic response of the knee in juvenile rheumatoid arthritis

The objective is to study the role of power Doppler sonography (PDS) in assessment of therapeutic response in juvenile rheumatoid arthritis (JRA) of knee joint. Thirty patients (age range 3-11 years) of JRA with knee joint involvement were selected for this study. Clinical assessment and ultrasound was done on the same day and repeated at the end of second and sixth month of therapy. All patients received naproxen (15-20 mg/kg/day) for a period of 6 months. Total clinical score (TCS) was calculated as sum of scores of pain, articular swelling and functional impairment. PDS was performed and degree of vascularity was assessed and graded. Total USG score was obtained by adding sum of scores of synovial effusion, synovial thickening and PDS. Results were compared between the total clinical score and the total ultrasound score and between clinical groups at baseline, end of second month and end of sixth month. There were statistically significant differences between clinical and ultrasound indices and confirmed that PDS is more sensitive in detection and follow-up of clinically silent cases of JRA. PDS holds great promise for detection of active synovial inflammatory disease in sub-clinical cases of JRA and is useful in objective assessment of therapeutic response.

Mineral content of insect infested stored legumes treated with edible oils.

Mineral content of three insect (pulse beetle, Callosobruchus chinensis L.) infested legumes viz. chick pea, mung pea and pigeon pea stored for six months and treated with three edible oils viz. groundnut, mustard and coconut oil has been studied. With increase in storage period significant increase in calcium, phosphorus and iron content of untreated legumes was observed. After three months of storage slight increase in three minerals was observed in the legumes treated with coconut oil which continued till the end of sixth months as compared to other two oil treated counterparts. The storage period was associated with insect infestation which in turn influenced the mineral content of legumes. Ground nut and mustard oils were able to protect legumes for six months against insect infestation when applied in small amounts (0.5%). Whereas coconut oil had protective effect against insect infestation for four months only.