Case History Research Articles

Cardiac biomarkers as tools in the prediction and diagnosis of traumatic pericarditis and traumatic reticuloperitonitis in cattle and buffaloes

BackgroundIn the livestock industry, Foreign Body Syndrome is a devastating disease condition. Feeding management, lacking of food discrimination, and eating chopped food increase the risk of swallowing sharp foreign bodies in bovine species. In addition to the honeycomb cells shape of the reticulum, the contractions of the reticular wall, gravid uterine pressure, and parturition efforts, foreign bodies can penetrate the reticular wall, causing cascade of problems including traumatic reticulitis, traumatic reticuloperitonitis, and traumatic pericarditis. The present study was carried out to evaluate the diagnostic significance of cardiac troponin I rapid test cassette and other cardiac biomarkers including serum cardiac troponin I (cTn I), creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase enzyme (AST), in confirmed cases of traumatic pericarditis (TP) and/or traumatic reticuleoperitonitis (TRP) in cattle and buffaloes.MethodsA total number of 30 animals (22 cattle and 8 buffaloes) with different signs such as anorexia, jugular distension, brisket edema, and signs of pain (reluctance to move, arching back, and abduction of the forelimbs) were included in the present study. Based on case history, clinical signs, ferroscopic, pericardiocentesis, radiographic and ultrasonographic examinations, TP were confirmed in cattle (n = 10) and buffaloes (n = 8) while TRP were confirmed only in cattle (n = 12). Additionally, 20 clinically healthy animals (n = 10 cattle and 10 buffaloes) were used as a control group. Blood samples were collected for determination of blood level of Tn-I, and activity of CK-MB, LDH, and AST.ResultsThe obtained results revealed a highly significant increase in serum cTn I in diseased cattle with TP and TRP (P = 0.00), while buffaloes with TP showed no significant changes in serum cTn I (P = 0.111). Both diseased cattle and buffaloes showed increased serum activities of CK-MB, AST, and LDH enzyme. On the other hand, cardiac troponin I rapid test cassette failed to detect cTn I in diseased animals.ConclusionThe study concluded that the cardiac troponin I rapid test cassette did not have a diagnostic significance and could not be used as a point-of-care under field condition for diagnosis of TP and TRP in large ruminants. However, the serum troponin I level is helpful in diagnosis of TP and TRP in cattle. Although cardiac biomarkers have some diagnostic values in TP and TRP, the traditional diagnostic methods (clinical, radiography and ultrasonography examinations) are crucial for thorough evaluation of TP/TRP cases in bovine.

Predicting the probability of complications during prostatectomy in pa-tients with prostate cancer using machine learning methods

Objective. To determine the probabilities of predicting possible complications after surgery in patients with the diagnosis of prostate cancer using artificial intelligence methods. Materials and methods. Case histories of 701 patients who underwent prostatectomy were analyzed in the study. The anamnesis, findings of clinical, laboratory and instrumental study, as well as objective data of clinical observations were evaluated. The average age was 64.72. On the basis of the set of examination results, patients were selected according to the following inclusion criteria: prostate cancer patients without confirmed metastases with disease stage from T1N0M0 to T3N0M0; absence of previous and concomitant special treatment (immunotherapy or targeted therapy); informed consent to the surgery. Logistic regression, a binary classifier using a sigmoidal activation function on linear combinations of features, was used as a machine learning model. Results. It was determined that the logistic regression model based on selected parameters (prostate volume, pain syndrome, disease duration), predicts the probability of complications quite well (TPR=1). The overall accuracy of the model is: Accuracy=0.98. At the same time, it can be noticed from the agreement matrix that the trained model plays it safe and classifies some cases without complications incorrectly in 5.3% (FNR=0.053). However, the model never made an error and did not classify cases with a high risk of complications as those in which such a possibility was unlikely. Conclusions. The results obtained show that on the basis of just three parameters (prostate volume, pain syndrome, duration of the disease), it is possible to build a fairly good predictive model of the probability of complications after prostatectomy based on such machine learning method as logistic regression.

Laparoscopic Heller’s cardiomyotomy as the main method for treatment of achalasia cardia: an evaluation of treatment results

Achalasia is an esophageal motility disorder characterized by symptoms of dysphagia, regurgitation of undigested food, respiratory symptoms (nocturnal cough, recurrent aspiration, and pneumonia), chest pain, and weight loss. The aim: to evaluate the results of surgical treatment for achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy in combination with Dor fundoplication. Materials and methods. To evaluate the treatment results of achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy with Dor fundoplication, we analyzed 30 case histories of patients who were treated in the period from 2011 to 2022. Inclusion criteria were age 18 years or older, diagnosis of stage II, III cardia achalasia confirmed using instrumental examinations. Exclusion criterion was stage I achalasia. The mean age of the patients was 53.0 ± 15.3 years. In terms of sex, this group was almost equal, there were 14 (46.7 %) women and 16 (53.3 %) men. The average duration of the disease was 5.0 ± 1.2 years. To determine the degree of achalasia, we used the radiological classification of the distal esophageal morphology in achalasia and distinguished 4 stages. Based on this classification, stage II achalasia was detected in 24 (80.0 %) patients, and stage III – in 6 (20.0 %), p = 0.0007, U = 180.0. Results. All the patients were operated on as planned. The total duration of preoperative preparation in the hospital was 0.8 ± 0.2 days. The main method of treatment in this group was laparoscopic Heller’s cardiomyotomy with Dor fundoplication. Conclusions. Laparoscopic Heller’s cardiomyotomy with fundoplication is currently one of the most effective methods of treatment for achalasia cardia. Minimally invasive surgical treatment methods for achalasia are effective in most patients, however, recurrence of symptoms in the long term occurs in 10.0–20.0 %, leaving open the question of finding new effective methods for the treatment of this pathology.

The spectrum of infections identified in pregnant women with different types of fetal growth restriction

BACKGROUND: Bacterial, viral and protozoal infections can cause miscarriage, antenatal death, congenital organ abnormalities or other limited consequences depending on the pathogen. The role of infection processes identified during pregnancy on placental pathology and fetal growth restriction. AIM: The aim of this study was to conduct a comparative analysis of infections identified in pregnant women with different types of fetal growth restriction, as well as to assess a potential impact of identified infections on the outcomes of fetal growth restriction in newborns in the same groups. MATERIALS AND METHODS: We performed a retrospective analysis of outcomes for 394 pregnant women with an established diagnosis of fetal growth restriction, who had given birth from 2018 to 2022 in the Perinatal Center of the Arkhangelsk Regional Clinical Hospital. Maternal and neonatal case histories were obtained using a continuous sampling method. Considering the transition to new criteria for establishing the diagnosis of fetal growth restriction in Russia, we formed four study groups, of which only 139 cases met the Delphi criteria of clinical guidelines by Russian Society of Obstetricians and Gynecologists, 2021. In the selected groups, we analyzed the results of microscopic and microbiological tests of various localizations in mothers during antepartum examination, as well as postpartum examination of the placenta and culture tests in newborns in their relation to adverse outcomes. RESULTS: A high prevalence (25–70.4%) of positive bacteriological findings was revealed in all of the study groups. The frequency was highest in the group of pregnant women with fetal growth restriction before 32 weeks (90–92%). Combined infections (two or more localizations) were noted in 59.2% of pregnant women in groups with early fetal growth restriction compared to 23.3% in late fetal growth restriction groups. In all cases, we observed a direct relationship between the severity of fetal growth restriction and the prevalence of infections. The range of infections identified during routine examination of pregnant women is quite limited; Candida spp. (from 40.8% in the control group to 75% in the comparison group), Escherichia coli (from 22.9 to 33.3%, respectively), and Chlamydia trachomatis (from 4.5 to 23.5%, respectively) being identified most commonly. In a morphological study of the placenta, infectious and inflammatory lesions were the most significant and ranged from 100 to 81.4% of cases in groups with early and late fetal growth restriction, respectively, with signs of hematogenous transmission prevailed. When analyzing infectious lesions in fetuses, we have found the presence of three and more localizations of the infectious process in 90 to 45% of cases with a fatal outcome for early and late fetal growth restriction, respectively. In the control groups, similar rates were 40 and 15.8%. When assessing the distribution of various types of infectious process in newborns, Candida spp., Escherichia coli, and Enterococcus faecalis also took the lead in all cases. However, the percentage of the same etiology of maternal and neonatal infections turned out to be very low (from 0 to 31% for individual pathogens), which makes it difficult to apply preventive treatment during pregnancy. CONCLUSIONS: Authors identified indirect but numerous signs of significant involvement of infectious processes in the development of fetal growth restriction, especially its early type, as well as the influence of infections on the outcomes for such newborns. In most cases, infectious processes during pregnancy are subclinical. Current screening of pregnant women is insufficient to identify high-risk groups. Examination of pregnant women for infections carried out by culture tests provide low-component and, most likely, incomplete information.

The underlying factors of occurrence of Mucormycosis in post-COVID-19 patients – A meta-analysis of case histories

Mucormycosis is a life-threatening fungal infection caused by fungi of the order Mucorales. It usually affects people with weakened immune systems, such as those with uncontrolled diabetes, acquired immunodeficiency syndrome, iatrogenic immunosuppression, and hematological malignancies, as well as individuals who have had organ transplants. The type of mucormycosis a person suffers from is often determined by their underlying conditions. The most common types are rhino-cerebral mucormycosis, pulmonary mucormycosis, cutaneous mucormycosis, cerebral mucormycosis, gastrointestinal mucormycosis, and disseminated mucormycosis. The incidence of mucormycosis has been increasing over the years, with an overall mortality rate of 54%. Recent cases have shown a correlation between COVID-19 and mucormycosis. Using anti-inflammatory drugs to combat the cytokine storm associated with COVID-19 can weaken the immune system, making individuals more susceptible to opportunistic fungal infections like mucormycosis. Underlying health conditions further exacerbate the condition. This study reviewing 198 cases of mucormycosis and conducting a meta-analysis found that post-COVID-19 patients most commonly developed rhino-orbital-cerebral mucormycosis, followed by pulmonary and gastrointestinal mucormycosis. The study also identified diabetes as the most common underlying factor contributing to the development of mucormycosis in post-COVID-19 patients, followed by hypertension and obesity. The study also examined the influence of age, affected organs, and the use of certain drugs on the development of mucormycosis. Age was found to be a significant factor in the infection. This meta-analysis is one of the first to compare post-COVID mucormycosis cases with those from the pre-COVID era. The hope is that this study and analysis will help identify the determinants of mucormycosis in post-COVID patients and aid the scientific community in finding a solution to this problem.

Discourse on Blasphemy In Ibn Abdulwahhāb's Kitabut-Tawhid, Vis-À-Vis Non-Muslims’ Attack on Islam In Yorubaland

Blasphemy has become a common practice among non-Muslims in Nigeria, most especially among the people in the northern part of the country. Muslims in the north are commonly reacting to this act. Their actions include the killing of the perpetrators. The thrust of this work is to discuss the relevance of the discourse on the blasphemy of Shaykh Muhammad Ibn AbdilWahhab in his book of Tawhīd. The methods employed are analytical and historical. The analytical method helped in analyzing the issue as rampant in the country, most especially in the north and how is tremendously uncommon in Yorubaland. The historical method also assisted in tracing the histories of blasphemous cases in Nigeria. The major findings in the work include the concept of blasphemy in Islam, Christianity, Judaism and Hinduism, among others. So also, the cases of blasphemy in Nigeria: Yorubaland in focus, however, includes the current issue i.e. the case of Abdul-Azeez Adegbola and TaloLohun (who is God). More so, the work encapsulates the punishment of blasphemy in Islam. However, the statements of scholars of Islam are mentioned. The work was concluded and certain recommendations were mentioned, to curb the menace of blasphemy in Nigeria and also a way of advising the Muslims in doing away with jungle justice but rather referring the cases to the appropriate authorities

Acute kidney injury of mild to moderate severity in patients with COVID-19

THE AIM: to study the incidence of mild to moderate acute kidney injury in patients with COVID-19.PATIENTS AND METHODS. The data of the case histories of 200 patients hospitalized in the infectious diseases department of the Naro-Fominsk Regional Hospital of the Moscow region for COVID-19 were analyzed, mainly with mild to moderate severity of lung damage according to computed tomography, which do not require respiratory support and renal replacement therapy.RESULTS. Despite the fact that the analyzed group of patients did not have the most severe course of COVID-19, the first stage of acute kidney injury was detected in 22.5% of patients, which was manifested by a temporary decrease in hourly diuresis, increased creatinine, urea, proteinuria and erythrocyturia.CONCLUSION. The development of acute kidney injury was most often associated with older age, coronary heart disease, arterial hypertension, diabetes mellitus and obesity.

Examining the experiences of vulnerably housed patients visiting Kingston, Ontario’s emergency departments: a qualitative analysis

IntroductionVulnerably housed individuals access emergency departments (EDs) more frequently than the general population. Despite Canada’s universal public health care system, vulnerably housed persons face structural barriers to care and experience discrimination from healthcare providers. This study examines how vulnerably housed persons perceive their experience of care in the ED and Urgent Care Center (UCC) in Kingston, Ontario and aims to develop strategies for improving care for this group.MethodsAs part of a larger mixed-methods study, narratives were collected from participants attending the ED/UCC as well as community-based partner organizations, asking them to describe an experience of a recent ED visit (< 24 months). Participants could identify as members of up to three equity-deserving groups (EDGs) (for example homeless, part of an ethnic minority, having a disability, experiencing mental health issues). Coding and thematic analysis were completed for the experiences of participants who identified as being vulnerably housed (n = 171). Results were presented back to individuals with lived experience and service providers working with clients with unstable housing.ResultsParticipants reported judgement related to a past or presumed history of mental health or substance use and based on physical appearance. They also often felt unheard and that they were treated as less than human by healthcare providers. Lack of effective communication about the ED process, wait times, diagnosis, and treatment led to negative care experiences. Participants reported positive experiences when their autonomy in care-decision making was respected. Furthermore, having a patient-centered approach to care and addressing specific patient needs, identities and priorities led to positive care experiences.ConclusionsThe ED care experiences of vulnerably housed persons may be improved through healthcare provider training related to trauma-informed and patient-centered care and communication strategies in the ED. Another potential strategy to improve care is to have advocates accompany vulnerably housed persons to the ED. Finally, improving access to primary care may lead to reduced ED visits and better longitudinal care for vulnerably housed persons.

Predicting the course of uveitis against the background of juvenile idiophatic arthritis when using topical therapy regimens. The results of mathematical modeling

BACKGROUND: Juvenile idiopathic arthritis is the most common rheumatic disease in children, and uveitis is its most destructive extra-articular manifestation. Despite the existence of Federal clinical guidelines for the management of these patients, their treatment is largely based on the experience of doctors and varies greatly even within the same country. AIM: The aim of the study is to find factors for predicting the course of uveitis and optimizing therapy. MATERIALS AND METHODS: The case histories of 150 children aged 1.5 to 17 years with active uveitis in the structure of juvenile arthritis were analyzed using multifactorial modeling (construction of classification trees). RESULTS: The fact of a significant influence of the time elapsed from the onset of rheumatic disease and uveitis until the start of therapy by genetically engineered medications (tumor necrosis factor alpha inhibitors) in treatment programs has been established. CONCLUSIONS: Thus, the inclusion of this factor into the group of controlling ones makes it possible to achieve inactive uveitis status after 1, 3, and 6 months in a higher percentage of cases. However, the obtained data still require additional clinical confirmation.

Fentanyl-related deaths in Ontario, Canada: toxicological findings and circumstances of death in 4395 cases (2020-22).

Over the last 20 years, there has been a significant increase in fentanyl-related deaths in Ontario, Canada. This report examines toxicological findings in a series of death investigations in which fentanyl was quantitated to identify the prevalence, trends, and demographic data associated with fentanyl in Ontario, Canada, and to highlight the changes in these trends since fentanyl began appearing in casework in Ontario in the early 2000s. A retrospective study of all cases in which fentanyl was quantitated in blood, using liquid chromatography (LC)-tandem mass spectrometry (MS-MS), was conducted for the time period between 1 January 2020 and 31 December 2022. A total of 4395 cases were included; 77% of the decedents were male, and 23% was female with ages ranging from 0 to 95 years. The most frequently classified cause of death was mixed drug toxicity (69%) followed by fentanyl intoxication at 19%. Less than 10% of cases where fentanyl was quantitated were classified as nondrug-related deaths. Fentanyl concentrations in all cases ranged from 1.3 to >2000 ng/mL. Other drugs were frequently detected with fentanyl. In mixed drug toxicity cases, stimulants were the most frequently encountered class of drugs: cocaine was identified in 51.8%, and methamphetamine was observed in 43.0% of cases. Detailed reports for select cases were included to provide additional insight into the different case types and to show the difficulty in interpreting blood concentrations without additional detailed case histories. This study provides valuable information for the scientific and medical community regarding the continued use of fentanyl and how patterns of fentanyl use have evolved since it began to appear in forensic casework.

Factors affecting the course and prognosis of implant-associated infection caused by &lt;i&gt;Klebsiella&lt;/i&gt; spp.

Background. The outcome of complex treatment of implant-associated infection (IAI) depends on various factors, but one of the most important is the etiology of the inflammatory process. Treatment of orthopedic infection caused by Gram-negative microorganisms in general and representatives of the family Enterobacteriaceae in particular causes many difficulties, one of which is the rapid growth of antibiotic resistance. Aim of the study — to evaluate the factors affecting the course and prognosis of implant-associated infection caused by Klebsiella spp. Methods. We performed a retrospective analysis of case histories of 85 patients who underwent treatment of IAI caused by Klebsiella spp. in the clinical departments of the center from January 1, 2017 to December 31, 2021. According to the results of the telephone survey, the patients were divided into 2 main groups depending on the outcome of the 2-year follow-up period determined in accordance with the Delphi criteria. Results. It was found that the prognosis was significantly worsened by the number of sanitizing surgical interventions in the anamnesis (p = 0.022), the need for sanitizing intervention in the early postoperative period (p0.001) and the presence of Klebsiella spp. growth in postoperative culture tests (p = 0.002), hypoalbuminemia on 7-14 days after the surgery (p = 0.008). The administration of trimethoprim-sulfamethoxazole for the outpatient treament stage significantly improved the outcome (p = 0.038), which is most likely due to a high proportion of polymicrobial associations — 69.5%. Conclusions. There is a statistically significant direct relationship between the probability of an unfavorable treatment outcome of patients with IAI caused by Klebsiella spp. and the number of sanitizing surgical interventions in the anamnesis, low serum albumin (g/l) on 7-14 days after the operation, revision intervention in the early postoperative period, positive growth of Klebsiella spp. in postoperative culture tests. The probability of a favorable outcome was increased by the prescription of trimethoprim-sulfamethoxazole for oral administration at the outpatient stage.

Identifying and Addressing Functional Communication Challenges in Patients With Behavioral Variant Frontotemporal Dementia.

We describe the communication challenges of four patients with a neurodegenerative disorder consistent with behavioral variant frontotemporal dementia (bvFTD), characterized by early behavioral and personality changes. By describing their clinical profiles, we identify common barriers to functional communication in this population and provide recommendations for how speech-language pathologists (SLPs) might contribute to minimizing them. Four patients with bvFTD were selected from a cohort of patients with progressive communication impairments. Three of them returned for at least one follow-up visit. Case histories are presented along with the results of comprehensive speech and language, neuropsychological, and neurological testing. At the time of initial evaluation, patients were between the ages of 54 and 66 years and had been experiencing symptoms for 1.5-6 years. Consistent with their bvFTD diagnoses, all patients had prominent behavioral and personality changes that impacted communication. Patients 1 and 2 also had mild aphasia at enrollment, primarily characterized by anomia and loss of word meaning. Patients 3 and 4 both had apraxia of speech and moderate-to-severe aphasia at enrollment with prominent anomia and agrammatism. All four patients had impaired executive functioning and relative sparing of visuospatial skills; episodic memory was also impaired for Patients 2 and 4. Even though functional communication was progressively limited for all patients, none of them received regular support from an SLP. This case series adds to a scant, but growing, literature demonstrating that patients with bvFTD have communication impairments. SLPs are uniquely positioned to identify barriers to functional communication and to provide tailored strategy training to the patients and their care partners over the course of their disease. Systematic evaluation of the efficacy of treatment in this population would be valuable. https://doi.org/10.23641/asha.25933762.

Racial Rage, Racial Guilt: The Uses of Anger in Asian America

ABSTRACT Asian Americans are conventionally described as “middle-man minorities,” outside of dominant racial paradigms of White and Black, adjunct to White privilege and exempt from the brunt of systemic violence directed against Black people. Historical accounts of the in-betweenness of Asian Americans trace their origins to how Asian coolie labor has served to triangulate White capital and African slavery over the course of European modernity. If this is the material history of in-betweenness, what is the psychic corollary of the middle-man thesis? Through an analysis of the Netflix dark comedy series Beef, as well as case histories of Asian American patients and students, we argue that the psychic effects of occupying a racially intermediate position implicate an unexplored terrain of racial rage and racial guilt that Asian Americans are insistently socialized to hold on behalf of others.

Analysis of labour accidents caused by slope failure during slope cutting and application of a rapid checklist for risk management in Japan

Slope failure during or immediately after slope-cutting can cause fatal accidents. This study analyses the characteristics of labour accidents caused by slope failure during slope-cutting in Japan and presents a countermeasure to prevent accidents caused by slope failure, such as the implementation of a slope guideline by MHLW. A case history conducted during slope-cutting and nailing was presented as an example of the application of the slope guideline to ensure safety. Furthermore, monitoring methods were implemented to gain a quantitative understanding of slope deformation. Geological conditions other than those assumed prior to excavation and small collapses attributed to groundwater are indications of landslide risk. The guideline's quick checklist reflects the slope condition or deformation, allowing the client, designer and contractor to discuss and agree on a quick solution to a problem. The case study confirmed the effectiveness of the slope guideline as a tool for sharing information during construction.

A retrospective study on hearing outcomes of infants of COVID-19 mothers pre-vaccination era

Background: A COVID-19 infection can result in a variety of symptoms. Findings must be carefully reviewed because there is still a dispute over the potential involvement of the audiovestibular system. Moreover, there is debate over the intrauterine transfer of COVID-19 infection from mother to fetus in pregnant people. There are not many investigations on the audiovestibular symptomatology of infants exposed to COVID-19 during pregnancy. Aims and Objectives: This study looks at any potential links between the COVID-19 gestational infection and the start of hearing impairment in babies. The verification of hearing’s engagement in COVID-19 allows for the planning of the time and methods for children’s audiological evaluations. Materials and Methods: Newborns had audiological examination and screening for hearing loss. The automatic transient evoked otoacoustic emissions (OAEs) test is used to evaluate newborns for hearing impairments before they are released from the hospital. By employing the COVID-19 case history, otoscopy, acoustic immittance test, transient evoked OAEs test, and mother, pregnancy, and perinatal case histories, an audiological examination is conducted on children under 3 months of age, with 2 weeks, 1 month and 3 months of age follow-up. Results: The research comprised 100 children. Of these infants, 90% were part of the neonatal hearing screening initiative. Due to isolation protocols, the remaining 10 neonates did not undergo hearing screening; instead, a direct audiological examination was performed on them. Out of the 90 newborns that were tested, only 11 had a bilateral REFER test result, but the audiological examination revealed a normal hearing threshold. Conclusion: There is no data in this study that a mother’s COVID-19 infection results in hearing loss in newborn.

Epidemics in the Vilayet Of Kosovo (1877–1912)

With the increase in activities and interaction between societies, the rate of spread of epidemics has also increased. Given that the physical structure and location of the Vilayet of Kosovo during the Ottoman period was in the middle of the Balkan Peninsula, connecting the land routes with the Central Europe, it had become a destination where epidemics spread easily. The main purpose of this paper is to analyse and evaluate epidemiological diseases in the Vilayet of Kosovo such as cholera, smallpox, dysentery, rubella. The main objective of this work is to cover the years 1877–1912. This paper, which deals with the epidemic in the Vilayet of Kosovo, investigates the historical background of the conduct of the central and local authorities as far as health policies and public health were concerned in the face of deadly infectious diseases. At this point, administrative and sanitary measures taken by the relevant institutions in the Vilayet of Kosovo had been identified, such as the employment of health personnel, the distribution of vaccines, border blockage, the restriction of the movement of people and putting them in quarantine. In addition, attention has been paid to the assessment and analysis of health services and hospital infrastructure in the Zekirja Shabani, Marigonë Rizani Vilayet of Kosovo. This study, which contributes to the knowledge of the history of epidemiology and public health in the Vilayet of Kosovo, is mainly supported by documents from the Ottoman Archives of the Presidency in Istanbul. In addition, studies, theses and research papers on epidemiology and public health in the Ottoman Empire were used.

Understanding Mucocele of Tongue in Children: A Case Report

Introduction: Mucocele is cystic lesion that occur in oral cavity. Commonly it happens due to trauma or obstruction of minor salivary gland ducts. Certain mucoceles may heal spontaneously, while others might surgical intervention due to frequent recurrence. Mucoceles on the tongue are rare and typically occur on the underside, where the glands of Blandin and Nuhn are located. Appropriate diagnose and treatment must be chosen correctly. Case History: A 12-years old-girl presented of enlarged gum and recurrent swelling firstly noticed a month ago. Excision was done under local anesthesia using electrocautery. A clinical diagnose of mucocele was confirmed by histopathological examination. Discussion: Mucoceles on the tongue are uncommon and primarily occur on the ventral surface where the glands of Blandin and Nuhn are situated. Complete excision was done once the diagnosis was confirmed using electrocautery which have indicated that this method is faster, simpler, and causes minimal postoperative discomfort compared to conventional excision. To minimize recurrence, strategies such as removing surrounding glandular acini, excising or dissecting the lesion down to the muscle layer, and avoiding damage to adjacent glands and ducts are recommended. Conclusion: Mucoceles on the tongue are uncommon and primarily occur on the ventral. Since mucocele are asymptomatic, complete surgical excision of mucocele of tongue must followed by eliminate risk factors to prevent recurrency.

Dental behavior management for a 7-years-old patient with hearing impairment: A case report

Introduction: Hearing is one of the most important components in communication since hearing and speaking are the key for people in socializing. Patients with hearing impairment still need to visit dentist. Difficulties in communication will lead to difficulties in dental treatment. Case History: Explaining about dental behaviour management in 7-years-old girl with hearing impairment. Class 2 filling on tooth #55 which begin with a whole mouth prevention of dental caries was done smoothly with a better cooperation level. Discussion: A non-verbal communication using lip reading, show-feel-do, modelling, and picture exchange communication system (PECS) was selected as behaviour management to describe treatment procedures. During dental treatment using handpiece, hearing aid was removed to avoid disturbing sound. The child's cooperative level was recorded before and after treatment. Conclusion: Lip reading, show-feel-do, modelling and PECS methods are proven to establish good communication in dental practice for patient with hearing impairment.

Frenotomy for Ankyloglossia: Conventional technique under general anesthesia in pediatric patients

Introduction: Ankyloglossia, commonly known as tongue-tie, is a prevalent birth defect characterized by a shortened and taut lingual frenulum, resulting in various complications. It occurs more frequently in males and can lead to breastfeeding difficulties, poor weight gain, and challenges in oral hygiene. The purpose of this article is to discuss frenotomy as a surgical intervention for ankyloglossia, involving the removal of the lingual frenulum under general anesthesia. Case History: a 9-year-old male patient with class III ankyloglossia, experiencing difficulty in pronouncing words and maintaining oral hygiene due to a short lingual frenulum. Despite initial behavioral challenges, comprehensive dental treatment, including frenectomy under general anesthesia, was successfully performed. Discussion: Ankyloglossia, or tongue-tie, results from cellular degeneration of the lingual frenulum, often associated with a genetic mutation in the MTHFR gene, affecting folate processing. Tongue development involves the migration of muscles from pharyngeal arches, leading to attachment issues at the lingual frenulum, causing ankyloglossia. Untreated consequences include feeding difficulties, dental decay, and speech articulation challenges. Conventional frenotomy, a simple and efficient technique, offers rapid, cost-effective symptom relief, promoting smooth recovery and improved outcomes compared to laser procedures. Conclusion: frenotomy for ankyloglossia under general anesthesia effectively improves tongue mobility and alleviates associated symptoms. General anesthesia ensures patient comfort and facilitates precise execution of the procedure. The conventional frenotomy technique enhances tongue movements, highlighting the efficacy of surgical intervention for this condition.

Frequency and risk factors of early stent restenosis in patients with acute coronary syndrome

Objective: to evaluate the frequency and identify risk factors for the development of stent restenosis in patients with acute coronary syndrome (ACS) after percutaneous transluminal coronary angioplasty Material and methods. Retrospective analysis of 665 case histories of patients with acute coronary syndrome who were hospitalized from January to November 2023 was performed at the 1st stage of the study. At the second stage we analyzed the risk factors of in-stent restenosis development based on clinical and laboratory data in the compared groups of patients: group 1 (n=62) and group 2 (n=55). Results. Stent restenosis was detected in 62 patients out of 665 (9.3%). The risk of in-stent restenosis was significantly influenced by concomitant type 2 diabetes mellitus (OR 1.6 (1.2-2.3); p=0.007), IBS duration of more than 10 months (OR 2.24 (1.7-3.0); p=0.001) and stenting with a holometallic stent (OR 1.8 (0.9-3.4); p=0.049). Conclusion. The incidence of stent restenosis after stenting for ACS is 9.3%. Concomitant diabetes mellitus and duration of the underlying disease of 10 months are risk factors for early restenosis.