Group 1and Research Articles

Effectiveness of Modified Sacroiliac Belt on Pelvic Girdle Pain in Post Natal Women

Pregnancy-induced pelvic girdle pain (PGP) and low back pain (LBP) is common in post-natal women's. We conducted the study to evaluate the effectiveness of a modified sacroiliac belt on pelvic girdle pain in post-natal women. A total of 26 post-natal women between the age group of 18-35 years were selected and randomized into Group 1(N=13) received conventional sacroiliac belt, conventional physiotherapy and Group 2 (n=13) received modified sacroiliac belt along with conventional physiotherapy. Pre-assessment of pelvic girdle was assessed by (Pelvic Girdle Pain Questionnaire) PGPQ, and low back pain was assessed by Roland Morris low back pain and disability questionnaire (RMQ) and Post-interventional assessment was taken for the same after three months. Intragroup statistical analysis for PGPQ revealed not significant in post-intervention for Group 1 where P-value 0.3023 and was extremely significant for Group 2 (P value<0.0001). At the same time, the Intergroup intervention analysis showed an extremely significant difference between Group 1and Group 2 (p< 0.0001). The study concluded that Integrating Modified sacroiliac belt with conventional physiotherapy is more effective in reducing pelvic girdle pain in post-natal women with also benefiting to reduce the pregnancy-induced low back pain as compared to the conventional sacroiliac belt and conventional physiotherapy.

Novel Histopathologic and Immunohistochemical Observations in Explanted Orbital Peri-implant Capsules

ABSTRACT Purpose To describe the histopathologic and immunohistochemical characteristics of peri-orbital implant capsule and correlate the observed changes with delayed implant extrusion. Materials and methods Prospective, ex-vivo, histopathologic, immunohistochemical study of peri-implant capsules excised from capsules surrounding a poly-methyl metha acrylate (PMMA) implant. Thirteen capsules were harvested and divided into two groups. Group 1 (implant extrusion group) consisted of capsules harvested from around exposed/extruded implants and Group 2 (implant non-extrusion group) from implants that were surgically exchanged for volume augmentation. Data collected included demography, clinical presentations, etiology of the explantation, age of the capsule in months, inflammatory cells noted/high power field (HPF), CD3, CD20, and CD68, percentage Masson’s trichrome staining and mean capsular thickness. Results Mean patient age at presentation was 33 ± 13 years. Of the 13 capsules included, 7 belonged to group 1and 6 to group 2. Mean age of the fibro-collagenous membranes were 33 ± 57 months (median 13 months). Median CD3, CD20, and CD68 positivity was 80%, 9%, and 7% denoting a predominant T-lymphocytic response. Mean capsular thickness was 733 ± 422µ (median 678µ). Age of the harvested capsule showed a linear correlation with inflammatory cells/HPF (r = 0.93, p < .0001, 95% C.I. 0.73 to 0.98), with CD3 positivity (r = 0.6, p = .04, 95% C.I. 0.02 to 0.9), with capillary proliferation/HPF (r = 0.85, p = .003, 95% C.I. 0.43 to 0.96) and with percentage of cells showing Masson’s trichrome stain positivity (r = 0.71, p = .03, 95% C.I. 0.08 to 0.93). In the extrusion group, the capsules demonstrated high inflammation and low fibrosis. Conclusions PMMA orbital spherical implant incites a predominantly T-cell mediated inflammatory response which clinically presents as a peri-implant capsule. Increasing inflammation in the absence of significant fibrosis may be responsible for delayed PMMA implant exposure and extrusion.

Surgical management of compound odontomas: piezoelectric surgery or rotary instruments? A clinical study.

Odontomas are odontogenic tumors with a clinicopathological heterogeneity and a variable biological behavior. They usually are asymptomatic and can be discovered by routine radiographic investigations. This study aims to examine and compare intra- and postoperative consequences associated with use of piezosurgery and conventional rotary instruments for the removal of these oral lesions. Clinical and histological data of 120 consecutive patients with a mean age of 22 years and 1 month (age range from 19 years and 1 month to 25 years and 3 months) with compound odontomas, diagnosed by biopsy, were assembled. Of a total of 120, 100 oral lesions were placed in the anterior region of the maxilla; of these, 50 were extracted through traditional rotary instruments (GROUP 1) and 50 with piezoelectric surgery (GROUP 2). The remaining 20 oral masses took place in the posterior area of the same bone; of these, 10 were extracted through traditional rotary instruments (GROUP 1a) and 10 with piezosurgery. (GROUP 2b). The piezoelectric cutting device was (Mectron Medical Technology) with MT1-10 insert, pump level 4, vibration level 7. Finally, pain, swelling, and surgical time evaluation were measured 24-48-72 hours after the intervention. As regards the mean time of surgery, in Group (1 and 1a) were 12 minutes, while in Group (2 and 2a) were 18 minutes. Regarding surgery, the osteotomy of the cortical bone was performed in all cases. As regards the measure of bone saved, calculated through a surgery gauge, it was greater of 3.2 mm in Group (2 and 2a) than in Group (1and 1a). The main of facial swelling in both Groups (1 and 1a) was 5.82 mm and 2.23 mm for the Groups (2 and 2a) immediately after surgery. Piezosurgery produced less postoperative discomfort about the swelling. It is an effective technique in daily surgical practice, especially as regards the safety of soft tissues, bone, and nerves.

Treatment strategies of defect nonunion with vascular damaged by induced membrane technique: Is two-stage treatment sufficient?

Introduction: Defect nonunion is often associated with vascular damaged, concomitant infection and unfavorable soft tissue. Although several procedures used for bone defect nonunion, recently the induced membrane (IM) technique has gained great popularity in the world. The aim of this article is to evaluate the efficacy of vascular damaged nonunions with treated IM technique.Patients and Methods: This retrospective study included tibial defect nonunions of twenty-four patients (22 men, 2 women) with treated IM technique, from January 2014 to December 2018. According to the angiography of the extremity, a decrease in blood flow or obstruction in arterial vessels was suggested as vascular damaged group (n = 11) (Group 1), without vascular damaged group (n = 13) (Group 2). All surgeries applied during IM technique treatment including start with cement insertion and until last control were defined as number of surgeries.Results: The average time to union (40.18 ± 10.01 weeks – 38.61 ± 11.20 weeks) and the mean defect size (6.54 ± 1.75 cm – 6.61 ± 1.85 cm), no statistical differences were found between 2 groups (p >0.05). The average of spacer use was 11.27 (6 to 16) and 7.23 (6 to 10) weeks in group 1and 2, respectively. The mean number of surgeries was 3.91 ± 0.83 (at least 3 and at most 5) in group 1 and 2.31 ± 0.48 (2 to 3) in group 2.Conclusion: Although nonunions with vascular damage may require more surgeries and duration to spacer, a similar time to union and union rate were achieved compared to without vascular damage.

ASSOCIATION BETWEEN EMOTIONAL-VOLITIONAL DYSFUNCTION AND FEATURES OF AGGRESSION OR HOSTILITY IN MENS WITH DIFFERENT FORMS OF SUBSTANCE ADDICTIONS: A CROSS-SECTIONAL STUDY

The aim: The research aim was to study features of emotional-volitional sphere and its association in mens with different forms of Substance Addictions. Materials and methods: We examined 146 patients with alcohol and drug addictions using Toronto Alexithymia Scale, Zverkov-Eidmann`s questionnaire and Buss-Durkee questionnaire. Results: The study showed an increase in the overall level of alexithymia, a moderate level of aggressiveness and a sufficient level of volitional self-regulation without a significant difference between the groups. The indirect correlation of "persistence" with the "general level of alexithymia", "difficulty identifying feelings" and "physical aggression" in group 1 and at the same time the indirect correlation between "self-control" and "verbal aggression" and "volitional self-regulation" with "difficulty describing feelings" can be explained by the opposite meaning of these concepts and phenomena themselves.However, it is interesting that the indicators "physical aggression" and "difficulty describing feelings" in group 2 were significantly lower, but at the same time correlated with "general level of alexithymia" and "irritability", respectively. On other hand in group 1 the indicator "suspiciousness" is directly related to the "general level of alexithymia", but its level is significantly lower in comparison with group 2. Conclusions: The phenomenon of alexithymia is not only recorded in the clinical picture of patients with various forms of addiction, but can also induce the development of manifestations of aggressiveness and hostility in them. Correction of alexithymia is necessary to understand the emotional state of these patients and choose the right approach to their treatment and rehabilitation.

Immune Characteristics of Patients with Coronavirus Disease 2019 (COVID-19).

Up to now, little is known about the detailed immune profiles of COVID-19 patients from admission to discharge. In this study we retrospectively reviewed the clinical and laboratory characteristics of 18 COVID-19 patients from January 30, 2020 to February 21, 2020. These patients were divided into two groups; group 1 had a severe acute respiratory syndrome coronavirus 2 nucleic acid-positive duration for more than 15 days (n = 6) and group 2 had a nucleic acid-positive duration for less than 15 days (n = 12). Group 1 patients had lower level of peripheral blood lymphocytes (0.40 vs. 0.78 ×109/L, p = 0.024) and serum potassium (3.36 vs. 3.79 mmol/L, p = 0.043) on admission but longer hospitalization days (23.17 vs. 15.75 days, p < 0.001) compared to Group 2 patients. Moreover, baseline level of lymphocytes (r = -0.62, p = 0.006) was negatively correlated with the nucleic acid-positive duration. Additionally, lymphocytes (420.83 vs. 1100.56 /μL), T cells (232.50 vs. 706.78 /μL), CD4+ T cells (114.67 vs. 410.44 /μL), and CD8+ T cells (94.83 vs. 257.44 /μL) in the peripheral blood analyzed by flow cytometry were significantly different between Group 1and Group 2. Furthermore, there was also a negative correlation between lymphocytes (r = -0.54, p = 0.038) or T cells (r = -0.55, p = 0.034) at diagnosis and the nucleic acid-positive duration, separately. In conclusion, the patients with nucleic acid-positive ≥ 15 days had significantly decreased lymphocytes, T cell and its subsets compared to those who remained positive for less than 15 days.

Effect of Serum Ammonia, TNF-Alfa and IL-6 Levels on the Degree and Outcome of Hepatic Encephalopathy in Egyptian Cirrhotic Patients

Abstract Background: Hepatic Encephalopathy (HE) is a major complication of liver cirrhosis characterized with neuropsy-chiatric symptoms it's etiology is multifactorial. Aim of Study: Aim of the study serum ammonia, TNF-alfa and IL-6 levels on the degree and outcome of hepatic encephalopathy in Egyptian cirrhotic patients. Patient and Methods: The study included 90 patients with liver cirrhosis complicated with HE (patients group) and 60 cirrhotic patients without HE as control group (group 3), the patients group divided into subgroups according to the grade of encephalopathy from the beginning the study, group A encephalopathy: Grade 1 and 2 and group B encephalopathy: Grade 3 and 4. All patients were followed-up for 7 days, then divided into 2 groups according to the response to treatment; group 1: Complete recovery and group 2: With improper response. Results: There were statistical difference between patients groups (group 1and 2) and control group (group 3) in terms of blood ammonia levels (67.5±22.5, 13±4.8), serum TNF-a levels (21.6±3.2, 2.3±.2) and mean serum IL-6 (63.9±15.9, 4±1.29) respectively. There were statistical difference between group 1 and group 2 in terms blood ammonia levels (46±12.8, 86.5±30.5), mean serum TNF-a levels (7.1±2.9, 29.4±13.3) and mean serum IL-6 (19±9.2, 93.9±20.9). Results also, showed statistical significant difference between group 2A and group 2B in terms of blood ammonia level (79.2±20.6, 173.7±38.7), mean serum TNF-a levels (18.1±5.3, 39.9±14.5) and mean serum IL-6 levels (69.2±11.1, 118.2±13.8). In group 2 there were significant positive correlation between serum TNF with blood ammonia level (r=0.843, p=0.001), serum IL-6 (r=0.732, p=0.001) and between IL-6 and blood ammonia level (r=0.699, p=0.001). Conclusion: There is a strong relation between high blood level of ammonia, TNF alfa, IL-6 and grade and outcome of HE in cirrhotic patients.

Synthesis of Silver Nano-particles by Electrochemical Method and the Effects on the Serum Levels of Thyroid Hormones (T3, T4) in Adult Male Rats

Background: Silver nano-particles have anti-fungal properties. In the present study, silver nano-particles were synthesized by electrochemical method and its effects on the serum levels ofT3 and T4 hormones were investigated in adult male rats. Methods: In this experimental study, 28 adult male Wistar rats weighing approximately 180-220g were divided into 4 groups of 7 rats. The control group (no treatment). The experimental groups 1and 2 received silver intraperitoneal nano-particle doses of 25 and 100 mg/kg, respectively, for 14 days. The nano-aprticles had been synthesized at 75 seconds interval. The experimental group 3 received silver nano-particles that were synthesized at 300 seconds interval with an intraperitoneal dose of 25 mg/kg for 14 days. At the end of this period, blood samples were obtained from the rats’ hearts, and the serum levels of T3 and T4 hormones were measured. The results were statistically analyzed using ANOVA and Duncan tests. Results: At the completion of the study, there was no significant difference in the mean body weights in all experimental groups compared to control group. The results showed that the mean serum levels of T3 hormone in the experimental group1 increased significantly relative to the control group. However, there was no significant difference in the mean serum levels of T4 hormone in all experimental groups compared to that in the control group (P &lt; 0.05). Conclusions: Silver nano-particles increased the serum T3 hormone level in male Wistar rats.

Comparing the Effects of Individual Versus Group Face-to-Face Class Activities in Flipped Classroom on Student's Test Performances

BackgroundFlipped classroom is an active learning instructional design in which students are required to complete pre-class learning assignments and participate in concept application activities during class time. There is limited evidence describing the most appropriate type of class activity facilitating better test performance in students engaged in flipped classroom learning. PurposeThe purpose of this study was to compare effects of individual versus group face-to-face class activities in flipped classroom on student’s test performances. MethodA two-group post-test only true experimental study design was used. Students were randomly assigned in group 1 and group 2. Students in both of the groups completed identical pre-class learning assignments. Face-to-face class sessions in group 1 comprised of small group activities where as group 2 completed individualized tasks during class time. Students in both the groups completed a test comprising of assessment items in Fink’s taxonomy learning domains. Test scores in each domain were compared between the two groups. ResultsTest performance in Group 1 was better in learning domains of foundation of knowledge, application and integration whereas Group 2 performed comparatively better in domains of human dimension and caring. The study revealed that the mean test score of students in group 1 (face-to-face class activities) was better than group 2 (individual face-to-face class activities) and the difference across Group 1and Group 2 was significant (P = <0.001). ConclusionFlipped classroom design with group based face-to-face class activities yielded better test scores compared to the design comprising of individual face-to-face class activities.

Outcomes of Core Decompression with or without Nonvascularized Fibular Grafting in Avascular Necrosis of Femoral Head: Short Term Followup study.

Background:Avascular necrosis (AVN) of the femoral head usually occurs in the third to fifth decade. The treatment options depend on the stage of disease varying from nonoperative treatment to surgical procedure including core decompression (CD) with or without nonvascularized or vascularized fibular graft, muscle pedicle bone grafting, osteotomies, and arthroplasty. Finite life of the total hip arthroplasty (THA) prosthesis limits its use in young adults or in middle aged. In this study, we envisage to evaluate the clinicoradiological outcomes of CD and nonvascularized fibular grafting in early stages of AVN femoral head.Materials and Methods:Our study is longitudinal observational study including 76 hips (46 patients) in the age group of 18–48 years (mean 30.07 years). Ficat and Arlet staging system was used and only early stages, that is, Stage 1 (n = 36 hips) and Stage 2 (n = 40 hips) were included in the study. The cases with traumatic AVN were excluded. All patients in Stage 1 underwent CD (Group 1) and those in Stage 2 underwent CD and fibular grafting (Group 2). Preoperative Harris Hip Score (HHS), visual analog score (VAS), plain radiographs, and magnetic resonance imaging (MRI) were compared with serial postoperative HHS, VAS, plain radiographs, and MRI taken at different intervals.Results:Average period of followup was 53.5 months (44–63 months). Radiological progression was not seen in 55 hips out of 76 hips (72.3%), whereas 21 hips (27.6%) demonstrated signs of progression and collapse. Failure of surgery was defined as progression of the disease, which was 25% (n = 9) in Group 1and 30% (n = 12) Group 2. Median values of HHS at the end of the followup in Group 1 was 77 and in Group 2 was 71.5 compared to the preoperative HHS of 48 and 62 in Group 1 and 2, respectively. Median values of VAS at the end of the followup in Stage 1 was 0 and in Stage 2 was 2 compared to the preoperative VAS of 6 and 8 in Group 1 and Group 2, respectively.Conclusion:CD with or without fibular grafting is effective in preserving the sphericity of the femoral head and to delay the progression of the AVN of femoral head in the early stages, that is, Stage 1 and Stage 2 and aids in the early revascularization of ischemic femoral head and is a useful modality to negate or delay the requirement of THA.

Predictors for development of major cardiovascular events in elderly patients with severe and extremely severe chronic obstructive pulmonary disease in combination with early stages of chronic kidney disease

A prospective 6-month open, comparative study originally included600patients with IHD and stable angina who received chronic therapy with different forms of aspirin. In the prospective part of the study, these patients were subdivided into four groups: group 1 consisted of 200 patients switched to Aspirin Cardio; group 2 - 200pa - tients receiving chronic therapy with this drug; group 3 - 100 patients continuing on the Trombo Ass treatment; and group 4 - 100 pa - tients who had been treated with Cardiomagnyl for a long time. Efficacy, safety and compliance to the treatment were evaluated using standard tests and analogue scales; symptoms of dyspepsia were evaluated with a study-specific questionnaire. Switching to Aspirin Cardio (group 1) was on discretion of the physician in charge based on the history of gastrointestinal (GI) complications or significant manifestations of dyspepsia. The efficacy in prevention of cardiovascular events was similar in all groups. No "major" or "minor, clinically significant" bleeding (ISTH) were observed. Proportions of patients with "minor" bleeding were similar in all groups with a tendency towards their decrease under the Aspirin Cardio treatment. After switching to Aspirin Cardio, positive changes inseverity of GI symptoms by results of the questionnaire: a significant improvement of compliance by the treatment satisfaction index in group 1and 2; and a 1.7 time decrease in the proportion of ASA-noncompliant patients were observed. According totheresults ofROC analysis an average GI symptom score ≥3 predicted an improvement of compliance in case of switching to Aspirin Cardio with a diagnostic sensitivity of 72.3% and specificity of 51.1% (р=0.012) as well as alleviation of GI symptoms (sensitivity, 74.5%; specificity, 63.8%, р=0.001). Different dosage forms of ASA are characterized with similar efficacy in prevention of cardiovascular events and effects on the risk of bleeding. Aspirin Cardio showed a better tolerability due to a less effect on GI symptoms. Itprovided a better compliance to chronic treatment. This study confirmed advisability of using the proposed questionnaire to evaluate GI symptoms for specification of prediction and modification of therapy.

Experimental Pathological Studies on Ochratoxicosis in Broiler Chickens

Forty broiler chicks (Hubbard breed), two weeks old were used to study the pathological lesions and residues of ochratoxin A in some chicken organs. Experimental chicks were divided into two groups. First group (30 chicks) were fed on ration contaminated with 100ppb /kg ration, while second group (10 chicks) were kept as control and fed on ration free from OTA till the end of the experiment. Fifteen chicks from group 1and five chicks from group 2 were sacrificed 28 and 36 days post feeding (PF). The clinical signs, mortalities and lesions in addition to OTA residues were detected and recorded. The chicks in group 1 showed 20% mortalities beside diarrhea, dehydration and emaciation. The kidney lobules appeared pale with urates deposits due to intense nephrotic changes, nephritis, fibrosis and gout. The liver showed hepatic hemorrhages apoptosis, necrosis and hyperplastic bile ductules. Intense lesions in brain in the form of edema, meningeal lymphocytic cells aggregations, degenerated neurons and purkinje cells were recorded. GIT lesions (proventriculus and intestine) due to direct contact with OTA contaminated ration were also seen. OTA residue was higher in liver than kidneys while the lowest value was detected in skeletal muscle. It could be concluded that OTA induced neurotoxicity beside hepato-renal toxicity and GIT lesions due to its toxic effect and its adverse effect on growth performance.

Smile changes after intrusion of maxillary incisors with temporary anchorage devices (TADs) or accentuated compensating curve arch wire.

The aim is to evaluate changes of smile and gingival line after intrusion of maxillary incisors using mini-implant anchorage system or conventional accentuated compensating curve archwire. Twenty participants having deep overbite with age ranged from 18 to 24 years were enrolled in this study and were divided into two groups of 10 each. Intrusion of maxillary incisors was performed using mini-implant anchorage system in group 1 and by conventional accentuated compensating curve archwire in group 2. For each participant, lip position, dental and skeletal measurements related to the gingival line were recorded from standardized photographs and cephalometric analyses. Statistical analyses including t-test and Chi-square were used to evaluate differences between groups. There was an improvement of smile arc (consonance) from 30% smile consonance pretreatment to 90% consonance postintrusion in group 1, but the change was insignificant in Group 2. There was an increase in the outer intercommisural width in Group 2 compared to group 1 with a significant difference between both groups (P < 0.046). A significant decrease in the upper lip to upper incisal edge relationship in Group 1 and an insignificant decrease in Group 2 (P = 0.03 and P = 0.262, respectively) was detected. A significant decrease in overbite in Group 1and in Group 2 (P = 0.001) with an insignificant difference between both groups (P > 0.05) was also observed. Smile improvement in the mini-implant group was mainly the result of improved smile arc, increase in outer intercommisural width, decrease in upper lip to upper incisal edge relationship, and decrease in overbite. With the use of accentuated compensating archwires, the only significant change was increase in the interlabial gap.

Renal Hücreli Karsinomlu Yaşlı Hastalarda Sağkalım Sonuçları: Tek Merkez Deneyimi

Objective: The aim of the study was to investigate the survival outcomes in elderly patients with renal cell carcinoma (RCC) in our series. Materials and Methods: From January 2010 to June 2019, 174 patients with renal cell carcinoma who underwent surgery in our institution were analyzed. Age, gender, history, presentation, tumor size,tumor, node, metastasis (TNM) stage, histologic subtype and Fuhrman grade of the patients were recorded. Patients were divided into two groups with the cut off value 70 of age. Group 1 was defined as the patients below the 70 years of age, whereas, Group 2 was defined as the patients 70 years of age and older. Results: One hundred three patients were in Group 1 and 71 patients were in Group 2. Mean disease-specific survival(DSS) time was 140.3±6.7 months in Group 1, while it was 105.3±7.9 months in Group 2 (p=0.061). Mean overall survival time (OAS) was 132.0±7.5 months in Group 1 and 95.2±8.3 months in Group 2 (p=0.046). Actuarial estimated disease-specific survival at 5 years was 88.5% in Group 1and 78.1 % in Group 2 (p=0.061). Actuarial estimated overall survival at 5 years was 83.0% in Group 1 and 70.7 % in Group 2 (p=0.046). In multivariate Cox regression analysis, T stage and Fuhrman grade were independent prognostic factors for survival. Conclusion: Our study demonstrated that there was no statistically significant difference in disease-specific survival rates between elderly patients with RCC, those compared with younger ones. Our findings recommend that surgery may be an option for older patients with RCC to avoid the potential hazard.

Effect of Etching Time and Bioglass Nanoparticle Incorporation in adhesive resin on Microtensile Bond Strength to Enamel

Purpose : The aim of the study was to evaluate the effect of addition of 20% bioactive glass nanoparticles (bioglass) to a universal adhesive on its microtensile bond strength to enamel etched for different times. Methods: Twenty eight enamel central incisor specimens were used in this study and divided into four groups; E1, E2, E3 and E4. E1and E3 were bonded using unmodified universal adhesive while E2 and E4 were bonded using 20% bioglass modified adhesive. Groups E1 and E2 were etched with 37% phosphoric acid for 30 seconds while E3 and E4 were etched for 6o seconds. Adhesive was applied to the enamel surface using a microbrush. Adhesive was left undisturbed on the enamel surface for 20 seconds for group 1and 2 or 30 seconds for gp 3 and 4 before curing. Composite resin was built up and the specimens were subjected to microtensile bond strength testing. Results: Data was analyzed using T-test and one-way ANOVA. Results showed that bond strength values were statistically similar for both modified and unmodified adhesives. Thirty seconds etching time produced significantly higher bond strengths than sixty seconds etching for either adhesive. Conclusions: Within limitations of this study, it can be concluded that bioglass incorporation into the universal adhesive has no deleterious effect on bonding to enamel. Increasing the etching time is not recommended as it causes a loss of bond strength.

Correlation of Atherogenic Indices and IMA with Glycaemic Control in Diabetic Patients with and without Dyslipidemia

Atherosclerosis is one of the most common major complications associated with type 2 diabetes mellitus. Recent research suggests that the major culprits are modified proteins like LDL and albumin. Hence, this study focuses on the analysis of small dense LDL (sd LDL), oxidised LDL (ox LDL) and ischemia modified albumin (IMA) in type 2 diabetes mellitus patients with and without dyslipidemia and compare with healthy subjects. Further, correlate atherogenic indices (ox LDL/HDL and sdLDL/HDL) with glycated haemoglobin in these groups. 90 subjects aged between 30-60 years of both the genders were divided into 3 groups namely diabetic dyslipidemia (Group1), diabetic non dyslipidemia (Group2) and normal (group3). Serum lipid profile, ox LDL and IMA were estimated by spectrophotometric methods, sd LDL by calculation and glycated Hb by HPLC. Ox LDL showed an apparent increase in diabetics (group 1and 2) compared to normal. Though sd LDL levels in diabetic patients remained normal, the values doubled in dyslipidemic diabetics. sd LDL/HDL ratio was significantly high in both group1and 2 compared to normal. Furthermore, there was a significant positive correlation of this ratio with glycated Hb in both groups of diabetes. Serum IMA also increased significantly in diabetes with dyslipidemia compared to non dyslipidemic diabetics. The study highlights the fact that in diabetics, oxidatively modified proteins like LDL and albumin may increase with hyperglycemia even before dyslipidemia sets in. Hence, ox LDL and sd LDL may be included in the battery of extended lipid profile to monitor cardiovascular complications in diabetes.

Abstracts of the 22st Annual Congress of the SBRA, Brasilia/DF, 01-04 August 2018.

ObjectiveTo compare the results of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles in women with good prognosis, when they were electively transferred, a blastocyst stage embryo (group 1) versus a blastocyst stage and a mórula stage embryo (group 2).Methods35 transfers from January/2014 to January/2018 were included, these occurred in na assisted reproduction center. Selection criteria: Patients in first or second treatment for IVF/ICSI less than 35 years old, with body mass index <30kg/m2 who used their own oocytes with normal ovarian reserve (baseline of antral follicles ≥11) and recipients without age restriction. Cases of severe male fator (spermatic concentration below 1million/ml) were excluded. The transfer was realized on fifth day of embryonic development. Luteal phase support was performed with micronized progesterone 600mg/day vaginally and estradiol 6mg/day orally, started the day after eggs collection. The receivers used 6mg/day of estradiol valerate orally, beginning on first day of menstrual cycle and 600mg/day of micronized progesterone, vaginally, for five days before embryo transfer. Were evaluated: mean age of women under 35 years who used their own oocytes and donors; pregnancy rate (βHCG positive); pregnancy loss rate and ongoing pregnancy rate (fetus alive at 12th week of pregnancy).ResultsBetween group 1 (n=24) and 2 (n=11), mean age of women under 35 who used their own oocytes were 33(±1.6) and 31(±1.8) years old and for donors were 34(±0.5) and 29(±0) years old, for both groups, respectively. Pregnancy rate was 50% (12/24) for group 1 and 18% (02/11) for group 2 (p=0.02). Pregnancy loss rate was 17% (02/12) for group 1 and 50% (01/02) for group 2 (p=0.07). Ongoing pregnancy rate was 42% (10/24) for group 1and 9% (01/11) for group 2 (p=0.01).ConclusionThe analysis of our data shows that transfer another embryo with a slower development with a blastocyst, with the intention of increase pregnancy rates, can actually worsen the results. There is a worldwide trend about extending embryo culture by fifth or sixth day, then these data should be validated in a larger number of cases. The reason for an embryo with slower development impact on development of another embryo with normal development should be evaluated. We emphasize that the results were extracted from cases with good prognosis and can not be extrapolated to other cases.

Effect of application sequence of fluoride and CPP-ACP on remineralization of white spot lesions in primary teeth: An in-vitro study

ObjectiveTo explore how application sequence of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride influences remineralization of enamel white spot lesions (WSL) in primary teeth. DesignIn this in-vitro study, artificial WSLs were created in 130 primary teeth. Teeth were divided into 4 groups (n=27) and a control group (n=22) and exposed to one of the following remineralization regimens for 10 weeks: Group-1; 500ppm fluoride dentifrice; Group-2; 10% w/v CPP-ACP; Group-3; fluoride applied first, then CPP-ACP; Group-4; CPP-ACP applied first, then fluoride, and Group-5 was control. All groups were kept in a remineralizing solution. Mineral changes (ΔF) were quantified weekly using quantitative light-induced fluorescence. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS version 20.0). ResultsRemineralization occurred in all groups to different degrees; changes from baseline were significant in groups 1–4 (P≤0.05). Group-4 showed the earliest significant remineralization (after 2 weeks) among groups, (P<0.001). Group-4 showed maximum changes in ΔF among groups; however, only differences with Groups 1 and 5 were significant (P<0.05 and P<0.01, respectively). Group-3 showed better remineralization than Groups 1, 2 and 5; however, the difference was only significant with Group-5 (P<0.001). There were no significant differences between Group 1and 2, however, only Group 2 showed better remineralization than Group 5, (P<0.01). ConclusionCombined treatment with CPP-ACP followed by fluoride exhibited the best remineralization of white spot lesions in primary teeth in this study. Combined treatment with fluoride followed by CPP-ACP showed a tendency towards better remineralization than fluoride or CPP-ACP alone.

Risk of Intraatrial Thrombi After Thoracoscopic Ablation in Absence of Heparin and Appendage Closure

Catheter and surgical ablation of atrial fibrillation (AF) can be associated with a risk of thromboembolic events. The goal of this study was to assess optimal anticoagulation management during thoracoscopic ablation of AF. Fifty-two patients with persistent or long-standing persistent AF underwent hybrid ablation consisting of thoracoscopic ablation followed by electrophysiologic (EP) evaluation and consecutive ablation if indicated. The thoracoscopic ablation was performed using three different anticoagulation protocols: (1) without periprocedural heparin and without occlusion of the left atrial appendage; (2) with periprocedural heparin but without left atrial appendage occlusion; and (3) with periprocedural heparin and left atrial appendage occlusion. Transesophageal echocardiography (TEE) was obligatorily used to screen for intraatrial thrombi before the surgical and EP procedure and before hospital discharge for patients in protocols 2 and3. In group 1 (n= 20), 1 patient (5%) had a postoperative stroke with persistent neurologic deficit, and 6 other patients (30%) had a new thrombus in the left atrial appendage seen on the pre-EP TEE. In group 2(n=6), 3 left atrial appendage thrombi occurred (50%; 2on predischarge TEE and 1 on pre-EP TEE). In group 3(n= 26), no intracardiac thrombi were found on predischarge and pre-EP TEE, and there were no strokes in this group of patients, namely, the rates of thrombus or stroke were significantly reduced when compared with groups 1and 2 (p= 0.001). Thoracoscopic ablation of AF can be associated with a risk of left atrial appendage thrombus formation and possibly also stroke. With administration of heparin during the ablation, followed by occlusion of the left atrial appendage as a part of the procedure, this risk can be effectively reduced.

Evaluation of the Effect of Platelet Rich Fibrin on Alveolar Socket Healing in Glucocorticoids-Induced Osteoporosis in Rabbits (Histological and Immuno-histomorphometric study)

Purpose: The purpose of this study was to evaluate the effect of platelet rich fibrin on the healing of osteoporotic alveolar socket after tooth extraction in experimentally induced osteoporosis in rabbits. Materials and Methods: Thirty six adult female rabbits were used in this study. Rabbits were divided into 3 groups (group1, group2 &group 3: 12 for each group) then each group was divided into 3 subgroups (4 for each subgroups) according to the date of scarification at 7, 20, 30 days postoperatively. Group 1: (12 rabbits), alveolar socket was left empty after first molar extraction (didn’t receivePlatelet Rich Fibrin (PRF)). For the remaining 24 female rabbits: osteoporosis was experimentally induced by receiving 1.56 mg/kg dexamethasone (Dex) intraperitoneal injection daily for 2 months to induce osteoporosis - like condition. Group 2: (12 rabbits), osteoporotic alveolar sockets were left empty after first molar extraction (didn’t receive PRF). Group 3: (12 rabbits), osteoporotic alveolar socket received PRF after first molar extraction. The specimens were collected, prepared and examined by routine haematoxylin &eosin and immunostained by Osteoprotogrin (OPG) marker. Results: at 7, 20 and 30 days, the greatest mean value was recorded in group 1, followed by group 3, with the least value recorded in group 2. Both group 1and 3 revealed a decrease in area percent of OPG throughout the study, whereas in group 2 revealed an increase. Conclusions: The study offers a clear evidence that topical application of PRF in osteoporotic alveolar socket after tooth extraction accelerates and increases the rate of bone formation and maturation than in osteoporotic alveolar socket without PRF.