International Journal of Medical Science and Dental Research

Volume 6 Issue 4 (July-August 2023)

    • Evaluation of marginal fit of vertical versus horizontal finishing line designs of monolithic zirconia crowns (invitro study)
      Abstract: The aim of this invitro study was to evaluate the influence of two kinds of finishing line (FL) preparation designs (biologically oriented preparation technique (BOPT) and chamfer) on marginal fit of monolithic zirconia (ZrO2) crowns in anterior teeth.Material and Methods: as this study is a supplementation for a clinical part accomplished at the same time, so A total of 16 metal dies of upper two central were milled from STL file of in vivo case to replicate the creation of an all-ceramic full-coverage crown for central incisor teeth with two types of finish lines and thenThe monolithic zirconia restorations were fabricated by using a CAD/CAM system equipped with a scanner to digitalize the prepared metal dies. The marginal fit was evaluated bystereomicroscope.

      Conclusions:The marginal fit of both BOPT and chamfer designs was within the clinical acceptance limit.

      Keywords:: Finishing line , Marginal fit, monolithic zirconia crowns, Horizontal preparation, vertical preparation.

    • The impact of Nurses’ burn out on quality of care and Patient’s satisfaction outcomes
      Abstract: Nurses’ burn out is a significant problem in the healthcare system, and its consequences can be detrimental to both nurses and patients. Burnout can lead to emotional exhaustion, depersonalization, and decreased personal accomplishments, which can affect the quality of care that nurses provide. Burnout can also result in absenteeism, turnover, and decreased job satisfaction, which can have a negative impact on the healthcare system as a whole.Nurse burnout is a critical issue that requires attention in the healthcare system

      Objective: The purpose of this review is to systematically and critically appraise the current literature to examine the impact of nurses’ burnout on quality of care and patient’s satisfaction outcomes. Design and data sources: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted. PubMed and CINAHL search engines were used. The inclusion criteria were any primary studies examining burnout among nurses working in hospitals as an independent variable, in peer-reviewed journals, and written in English. The study was conducted from November 2021 to February 2022.

      Results: A total of 20 studies were included in the review. The outcomes associated with nurse burnout were quality of care and patient satisfaction. For these themes, nurse burnout was consistently inversely associated with outcome measures.

      Conclusions: Nurses’ burnout is an occupational hazard affecting healthcare system and patients at large. Nurse burnout is associated with worsening quality of care and decreased patient’s satisfaction. Traditionally, burnout is viewed as an individual issue. However, reframing burnout as an organizational and collective phenomenon affords the broader perspective necessary to address nurse burnout.

      Keywords: Healthcare system, Nurses’ burn out,Patient’s satisfaction, Patients’ outcomes, Quality of Care.

    • Ringworm Infection: A case of successful cure using Yoga Prana Vidya (YPV) Healing Protocols as a complementary therapy.
      Introduction:Fungal skin infections such as Ringworm (Tinea, or Dermatophytosis) are highly common in India due to the country's hot and humid climate. There are no current national or international management guidelines. This paper provides a thorough case study of a 24-year-old man who suffered fromringworm andwas effectively treated using the Yoga Prana Vidya way as a complementary therapy, despite being non-receptive to YPV Energy healing.
      Method:This study uses a case study method by collecting patient medical records, YPV healer’s records, and patient family feedback.
      Results:Positive results became apparent within a month of YPV healing intervention. The areas of infection started reducing and lightening in colour around the next two months. The patches had been reduced to 3 little ones by the end of the next 6 months, and they had already begun to heal and lighten in colour. After further 3 months, the patches had all but disappeared. After the next two months, the patient had fully recovered, the skin had returned to normal, and the tone of the skin on the back had been restored.
      Conclusions: Persistent long-term YPV healing in this case completely cured Ringworm incidence. Evidence shows several other ailments also have been successfully treated with the help of YPV healing, a safe and drug-free complementary and alternative medicine method. It is advised to do additional research utilizing suitable samples and techniques. A working understanding of the YPV system will be helpful to frontline healthcare professionals like doctors and nurses as a supplement to their individual specialties.

      Keywords: Ringworm, Dermatophytosis, Skin infections, Yoga Prana Vidya System ®, YPV ®

        • Analysis of Neutrophil-to-Lymphocyte Ratio between Obese and Non-Obese Women
          Abstract: Obesity is one of the largest global challenges for public health. Obesity is more prevalent in women than men. They also have a higher body fat percentage than men. Accumulation of fat cells in the adipose tissue causes stress and adiposity malfunction that leads to inflammation. Neutrophils are the first immune cells that infiltrate the adipose tissue. The neutrophil-to-lymphocyte ratio is a simple and cost-effective inflammatory marker. This study is quantitative with a cross-sectional design conducted on 70 subjects. The results showed the age of obese vs non-obese women (30.26 ± 8.58 vs 28.66 ± 8.72, p = 0.554), waist circumference (88.48 ± 4.23 vs 74.51 ± 3.50, p = 0.000), WBC level (6.49 ± 0.56 vs 6.25 ± 0.39, p = 0.002), neutrophil level (65.16 ± 3.73 vs 62.76 ± 6.13, p = 0.030), lymphocytes level (28.10 ± 3.40 vs 33.89 ± 5.38, p = 0.000), and NLR level (2.31 ± 0.34 vs 1.85 ± 0.39, p = 0.020).

          Keywords: Obesity, Women, NLR

            • Prevalence and Associated Factors of Dental Caries Among Secondary Level Students of Capital City of Karnali Province, Nepal
              Introduction:Dental caries is common and old infectious disease causes by streptococcus mutans. It is one of the major public health problems worldwide. Dental caries suffered from pain that cause to difficult sleeping, eating and communication. In Nepal, the morbidity of dental caries is very high among school children compared to other age groups. Therefore, the objective was designed toassess the prevalence of dental caries among secondary level students in Birendra nagar, Municipality, Surkhet.

              Methods:Descriptive cross- sectional study design. Data was collected from the selected secondary level school’s student by multi cluster method. Schools was selected by simple random sampling techniques.

              Result:Among 165 participants, the number of participants were from public and private school. The prevalence of dental caries among school children was found to be 20% and there was significant association between frequency of brushing with dental caries (P=0.05).

              Conclusion:Frequency of brushing and sugar contain food consumption are associated with the higher prevalence of dental caries among secondary school children. Regular dental visits and good brushing practice can reduce the prevalence of dental caries in secondary school children. Hence, continuous oral health programs including demonstration of proper brushing technique along with oral health awareness programs at school can help to reduce the burden of dental caries among school children.

              Keywords: Dental caries, Prevalence of caries, secondary schools student and Surkhet.

                • Arecanut (Areca Catechu L.) Chewing Causes Cancer,OSF and Others in Humans: is It Not A Mistaken Identity- An Overview
                  Arecanut or betel nut is the endosperm of the fruit of Areca catechu L. of Palmae family. This nut is also called as supari in Hindi. Arecanut is marketed mainly in two types, one called red supari, which is prepared from immature nuts; whereas the other type called white supari is prepared from ripe nuts. The arecanut is generally chewed along with several other ingredients such as the leaf or inflorescence of Piper betle vine, calcium hydroxide, catechu, tobacco etc. Such wet chewing mixture is called betel quid. Recently, several forms of dry chewing mixtures with or without arecanut have flooded the market in different trade names such as pan masala, gutkha,zarda, khaini, naswar, etc. The properties or the contents of such chewing mixtures naturally differ from that of sole arecanut. Nowadays, lots of Scientific and review articles were published with the title „arecanut chewing is cancerous to humans‟ or similar to that. If one goes through such articles critically it is seen that in most of the papers the data were collected either on betel quid, gutka or similar other chewing products and wrongly titled as arecanut chewing. It shows that such researchers and reviewers treated all these chewing mixtures as arecanut without understanding the differences between them. Such ambiguous research papers and review articles are retrieved, discussed and projected in this write up.

                  Keywords: arecanut, betel quid, gutkha, human cancer, wrong aetiology

                    • A Case Report- Sarcoidosis Presenting As Hypercalcemia
                      Sarcoidosis is a chronic granulomatous disease that affects multiple organs systems in the body with unknown cause. Most of the patients are free of clinical symptom, sarcoidosis should be considered in differential diagnosis if non-caseous granuloma is noted in biopsies. Here we present a case of sarcoidosis related hypercalcemia due to increased level of 1,25-dihydroxyvitamin D level that increases the absorption of calcium from intestine.

                      • Revitalizing Wound Healing Innovations Promoters Delivery Strategies
                        Skin injuries have a significant impact on the global health system, imposing a substantial burden on the economy and society. The low cure rate reported for these injuries exacerbating the situation further. Skin wounds can be categorized as acute or chronic, and the immune response plays a crucial role in acute wound healing. During this process, activated immune cells and factors initiate inflammation, aid in wound cleansing, and facilitate tissue healing. However, dysregulation of the immune system during wound healing can result in persistent inflammation and delayed healing, leading to the formation of chronic wounds. Chronic wounds are characterized by a microenvironment that exhibits an abundance of pro-inflammatory macrophages, increased expression of inflammatory mediators like TNF-α and IL-1β, heightened activity of matrix metalloproteinases, and an excess of reactive oxygen species. Furthermore, chronic wounds are often complicated by bacterial biofilms, which perpetuate the inflammatory phase and make the healing process extremely challenging. In this review, the role of innate and adaptive immunity in the pathogenesis of both acute and chronic wounds is discussed. Additionally, recent immunomodulatory therapy strategies are reviewed, including the modification of macrophage phenotype, miRNA expression, and targeting of pro- and anti-inflammatory factors to enhance wound healing.

                        Keywords: Wound healing, Skin injuries, immune system, Delivery strategies

                        • Retrospective Analysis of the Impact of Seasonal Factors, Laboratory Data, and Risk Scoring on The Prognosis of Patients With Pulmonary Thromboembolism
                          New markers are still needed in the diagnostic and prognostic monitoring of pulmonary thromboembolism. The study was conducted retrospectively in a single center at a tertiary education and research hospital emergency clinic. We used clinical, demographic and laboratory data of the cases. Out of 541 cases, 234 (43.3%) were male, with a mean age is 64.6±15.8 years. It was observed that PTE cases were most frequent during the winter season. In 95.6% of the cases, embolism was present in the segmental branch. Low atmospheric pressure was significantly higher in PTE cases with mortality. Patients with hypotension at the admission time and during follow-up, as well as those with RV/LV >1, had significantly higher mortality rates. The rates of MPV and RDW were significantly higher in patients who ended up with mortality compared to those who survived. Our study revealed that PTE cases most commonly presented during the winter season, and low atmospheric pressure had an adverse effect on the prognosis. Besides hematological parameters such as MPV and RDW, hypotension at admission time and a right ventricular diameter greater than the left ventricular diameter were also identified as negative prognostic indicators.

                          Keywords: Pulmonary Thromboembolism, MPV, RDW, Hypotension, RV/LV Ratio

                          • Determination of Right and Left Ventricular Echocardiographic Parameters that May Predict Instability in Patients with Stable and Unstable Ventricular Tachycardia During Electophysiological Study
                            Background: SCD constitute a significant part of cardiovascular deaths. More than 90% of such deaths result from VT and/or VF. Despite the use of new pharmalogical agents, RF ablation and ICD therapies, prognosis of patients with ventricular arrhytmias is still poor. Hemodynamic status during VT determines the treatment strategy.
                            Aim: We aimed to evaluate RV and LV echo parameters for prediction of hemodynamic instability in patients with stable or unstable VT during EPS.
                            Material-Metod: Patients with induced VT during EPS were included. Participants divided into two groups according to the hemodynamic situation as stable or unstable. Results: History of cardiovascular disease, diabetes, hyperlipidemia and medication with antiarrhytmic drugs were similar in both groups. However; prevalance of hypertension and the number of patients in NYHA class III were higher significantly more in the unstable VT group. LVEF values of unstable VT group were significantly lower and MPItri values were significantly higher.
                            Conclusion: Unstable VT may be observed in participants who are elderly, hypertensive, lower LVEF, higher MPItri values, have worse baseline NYHA functional. Participants with these clinical characteristics may need more aggressive pharmacologic therapy and ICD programming approach. More conservative medical therapy and ICD programming approaches may be used in participants without these characteristics

                            Keywords: Echocardiography,electrophysiological study,instability,ventricular tachicardia.

                            • Appropriate Use of Metered- Dose Inhalers Technique And Its Determinants among Asthmatic adult Patients Attending Chest Clinics In Al Noor Specialist Hospital And Hera General Hospital at Makkah Al- Mukarramah, 2018
                              Background:The most common route for managing bronchial asthma is using inhaled medications. Correct inhaler technique requires steps performed in sequence. However, various studies have reported critical errors in the inhaler technique by patients.
                              Objectives: To estimate the frequency and identify the determinant of the appropriate use of Metered- Dose Inhaler technique among asthmatic patients attending pulmonary clinics in Al Noor Specialist Hospital and Hera General Hospital, in Makkah Al Mukarramah, 2018.
                              Material and methods:Cross-sectional study included 145 asthmatic adult patients recruited from 30thSepmber – 30thOctober 2018 from pulmonary clinics at the mentioned hospitals. An Interview validated questionnaire was used-based on Asthma Control Test- for data collection and observational validated checklist.
                              Results:Among 145 asthmatic patients, the mean age was 48 and standard deviation ±16.1 years. Overall, asthma was controlled among 31.7% of patients, based on the Adult Control Test. The appropriate use of metered-dose inhalers technique by asthmatic patients was observed among 35.2% of them. It was significantly higher observed among patients live in Makkah (p=0.004), single patients (p=0.013), higher education (p=0.006), with income ranged between 9001 and 10000 SR/month (p<0.001) and young (p=0.005). Patients treated regularly by family physicians (p<0.001), those who had no other chronic diseases were more likely to use appropriately inhaler technique, Higher number of use of inhalers per week p=0.029, Patients who trained/retrained on the right way of using asthma inhaler and patients trained through YouTube or relatives p<0.001.
                              Conclusion: Improper inhaler use is common among adult asthmatic patients in MakkahAl- Mukarramah. However, it was not significantly associated with poor asthma control.

                              • Isolated pancreatic desmoid tumor, challenges in the diagnosis and management: a case report
                                Desmoid tumors are uncommon lesions involving the mesenchymal tissue. They commonly involve fascia, aponeurosis and periosteum. In the abdomen, they commonly involve mesentery and retroperitoneum. Isolated pancreatic desmoid is quite rare lesion. They can present as a solid or solid cystic mass. Here we report such a case in a 19 year old female who presented with pain abdomen and early satiety for a period of 2 months. On evaluation, we found a lesion arising from the body and tail of pancreas with combined solid and cystic areas. Considering the age, sex and imaging findings we planned for surgical resection suspecting solid pseudopapillary neoplasm of pancreas. However, intraoperative findings of stomach wall infiltration made us to perform wide local excision in the form of near total gastrectomy and distal pancreatosplenectomy. We present this case for the rarity of the lesion.

                                Keywords: Beta-catenin, Cystic neoplasm of pancreas, Familial adenomatous coli, Gardner syndrome, Solid pseudopapillary neoplasm.

                                • IS6110 Genomic Variability in the Mycobacterium Tuberculosis Complex Sputum Pulmonary TB and HIV TB Coinfection
                                  World's population is infected with MTB, a cause of death globally, with an increasing prevalence in several countries. To directly detect M.tuberculosis complex bacteria in non-cultured specimens, the target the IS6110 gene was used as a primer for in vitro amplification. Samples were analyzed by microscopy and molecular detection methods according to standard methods at the Clinical Microbiology Laboratory at Hasanuddin University. The 137 sputum samples of pulmonary TB patients. All samples were confirmed positive for TB and Rifampicin Resistance using the GeneXpert method. The analysis results showed that the sensitivity of the IS6110 PCR gene compared to TCM in pulmonary TB patients was 34%, while the specificity could not be assessed because there were no negative TCM results. In studying MTB infection, prompt diagnosis and identification are the main factors to control the spread of MTB bacilli and initiate appropriate tuberculosis management. The use of the IS6110 detection method is considered quite helpful because it can distinguish MTB from other Mycobacteria species. As a result, health facilities can provide a diagnosis fast and TB patients can immediately get appropriate TB drug therapy.

                                  Keywords: GeneXpert, Polymerase Chain Reaction (PCR), acid-resistant bacilli

                                  • The Effect of Serum Phosphorus Levels on Prognosis And Clinical Outcome in Patients 85 Years and older İn Intensive Care Unit
                                    Background: Phosphate metabolism is often not properly regulated in the course of acute diseases. There are very few publications investigating the relationship between serum phosphorus levels and clinical outcome, cost-effective and mortality in elderly patients.
                                    Aims: The aim of this study was to investigate the relationship between serum phosphorus level and disease course, cost to the healthcare system and clinical outcome in patients aged 85 years and older hospitalized in the intensive care unit.
                                    Study Design: This research is a cross-sectional study.
                                    Methods: Between January 1, 2015 and December 31, 2022, patients aged 85 years and older with no known malignancy or renal disease who were followed up in our clinic were included in the study. The first group (group 1) was hypophosphatemia (< 2.5 mg/dl), group 2 was normophosphatemia (2.5 mg/dl to 4.5 mg/dl) and group 3 was hyperphosphatemia (> 4.5 mg/dl).
                                    Results: Of the patients, 157 (41.5%) were male and 221 (58.5%) were female. According to rehospitalization rates, 6 patients (7%) in group 1, 15 patients (7.3%) in group 2 and 2 patients (2.3%) in group 3 were rehospitalized. According to the clinical outcomes in the first 30-day period, 44 patients (51.2%) in group 1, 103 patients (50%) in group 2 and 68 patients (79.1%) in group 3 died. According to the clinical outcome at the end of intensive care unit stay, 54 (62.8%) of patients in group 1, 117 (56.8%) of patients in group 2 and 70 (81.4%) of patients in group 3 died. There was no difference between the groups according to the cost per patient per day.
                                    Conclusion: Both hypophosphatemia and hyperphosphatemia contribute to mortality as a consequence of impaired energy metabolism. Restoration of normal serum phosphorus levels may have favorable effects on clinical outcome, especially in critically ill elderly patients.

                                    Keywords: Geriatry, Phosphorus, Mortality, Prognosis, Intensive Care Unit

                                    • Long-term Predictors of Rebleeding and Mortality in Patients with Acute Variceal Hemorrhage
                                      This study's objective was to elucidate the predictors of rebleeding and mortality over three and six-month intervals in cirrhotic individuals suffering from Acute Variceal Bleeding.Data encompassing symptoms, clinical and laboratory parameters, endoscopic findings, along with Child-Turcotte-Pugh and Model for End-Stage Liver Disease (MELD) scores were meticulously collected during emergency room presentations. Within the first three months, rebleeding was evident in 32 patients (31.1%), and mortality was recorded in 18 patients (17.5%). At the six-month mark, rebleeding was observed in 43 patients (41.7%), and 31 patients (30.1%) succumbed to their condition. Patients who re-bleeded within six months demonstrated a higher MELD score than their non-rebleeding counterparts (14 versus 11). Notably, individuals who expired within six months compared to survivors exhibited an admission heart rate of ≥100/min, elevated serum urea and INR levels, and diminished albumin levels. The assessment of clinical and laboratory variables such as elevated urea, prolonged INR, reduced platelet count, and low albumin levels, in conjunction with Child-Turcotte-Pugh and MELD scores, are pivotal in predicting long-term mortality in patients presenting with Acute Variceal Bleeding. This study thus underscores the value of these parameters in enhancing prognostic accuracy.

                                      Keywords: Acute Variceal Bleeding, Child-Turcotte-Pugh Score, Model for End-Stage Liver Disease, Mortality, Rebleeding.

                                      • Choice of Treatment of Sexually Transmitted Infections among Males in Rural Areas of South-South, Nigeria
                                        Sexually transmitted infection is an infection acquired during sexual intercourse (oral, vaginal, and anal), especially when having unprotected sex. This infection is easily spread in the rural areas where protective device is not patronized. Sexually transmitted infection (STI) is spread when the man or the woman involves in multiple sex partners and without putting on protective device. This study is aim to investigate the Choice of Treatment of Sexually Transmitted Infection Among Male in Rural Areas of South-South, Nigeria. This is a cross-sectional study involving 260 males with ages between 18 to 47 years. Each participant had one questionnaire to fill appropriately and independently after instructions were given to them by the researchers. The study lasted for three months. Statistical analysis of data was done using SPSS version 25. P value < 0.05 was considered significant for data. The results of the findings revealed that 7.70% were within 18-22 years, 15.40% were within 23-37 years, 11.50% were within 28-32 years, 15.40% were within 33-37 years, 19.20% were within 38-42 years, and 30.80% were within 43-47 years. The results also shows that 46.20% of the participants had primary level of education, 30.80% had secondary education while 23.10% had tertiary education. The study revealed that 69.20% of the participants had awareness about STI while 30.80% have no awareness. Again, 73.10% of the participants have no knowledge about STI. The research revealed that 73.10% of the participants have multiple girlfriends and 76.90% of them do not use protective device. The findings also revealed that 69.20% of the participants contacted STI and 96.20% preferred herbal medicine as their choice of treatment.

                                        Keywords: Choice, Treatment, Sexually, Transmitted, Infection, Male

                                        • Radiographic Evaluation of the Accuracy of Computer-Assisted Design and Manufactured (Cad/Cam) Three-Dimensional (3d) Device for Condylar Positioning in Mandibular Bilateral Sagittal Split Osteotomy (Clinical Trial)
                                          Introduction: Bilateral Sagittal split osteotomy (BSSO) is used to correct malocclusion by mobilizing the mandible during orthognathic procedures surgically. Although the use of condylar positioning devices (CPDs) seems prudent, theireffect on condylar position and relapse has not been studied deeply. Aim of the study: To radiographically assess the accuracy of CAD/CAM surgical guide for condylar positioning in the bilateral sagittal split osteotomy. Materials and Methods: The study recruited eight patients who had a nonsyndromic dentofacial deformity and underwent Bilateral Sagittal Split Osteotomy (BSSO). The surgery was planned according to (CAD /CAM) technology. After osteotomy, a preoperative guide was used, followed by a repositioning guide. Computed tomography scans were conducted on all patients one week preoperatively, immediately, and three months postoperatively to assess the condylar position. Results: The data are presented as median values with the 25th and 75th percentiles. Eight patients (37.50% females and 62.50% males) between the ages of 19 and 24 underwent BSSO with or without LeFort I maxillary advancement. The surgical procedure successfully corrected their skeletal deformities. Repeated measures analysis showed no statistically significant change in the Condylar Angle (°) among the different times of measurement (p=.233). Conclusion: The stability of the condylar head in position and patient postoperative occlusion is well assessed by 3D condylar positioning devices designed and manufactured by CAD/CAM technology in the mandibular BSSO.

                                          Keywords: Computer-Aided Design, Computer-Aided Manufacturing, Mandibular Condyle, Osteotomy, Sagittal Split Ramus.

                                          • Astrological Indian Medicinal Plants- A Review
                                            Ayurveda is not only a science of life but also a spiritual science of life. The aim of this esteemed science is the four Purusharthas viz; Dharma, Artha, Kama and Moksha. To attain Moksha one should follow the proper regimens which was detailed in Ayurvedic classics by adopting the daily using medicinal herbs. The concept of herbs and astrology reference can be traced in the Atharvana Veda in the form of Aushadhi Sookta. The planetary motions have direct impact on the human systems and seen the ill effects of in the body. To nullify the ill effects of the planets in the human body, several astrological medicinal plants have been enumerated. As it is observed the Vedic astrology describes 9 Grahas, 12 Rashis, and 27 Nakshatras. The positions of these Grahas, and Nakshatras at the time of birth and their movements in the celestial globe has influence on human systems. Therefore it is advised that every person should know the astrological medicinal plants and take care of those plants and to please the dominating Rashi and Nakshatra from their ill effects on the human body. Here an attempt is made to explore the medicinal plants belong to Navagrahas, Rashis and respective Nakshatras which will help humans beings to prevent the forthcoming health issues as well as in the treatment of chronic diseases.

                                            Keywords: Ayurveda, Astrological Medicinal Plants, Navagrahas, Rashis, Nakshatras etc.

                                            • Correlation of Carotid Artery Calcifications in Postmenopausal Women with Periodontitis: A Cross-Sectional Digital Panoramic Radiographic Study in East Godavari Population
                                              The prevalence of cardiovascular diseases, especially atherosclerosis-related incidents, is a significant cause of mortality worldwide. This study aims to investigate the correlation between carotid artery calcifications (CAC) detected through panoramic radiographs and Doppler ultrasonography in postmenopausal women with periodontitis.
                                              Cardiovascular diseases, particularly atherosclerosis, are leading causes of death, often involving calcium-rich fatty plaques on artery walls. This study focuses on the detection of CAC, a marker for cardiovascular events, in postmenopausal women. Menopause-associated hormonal changes increase the risk of stroke, particularly ischemic cerebral injuries due to atherosclerosis.
                                              The research involves 1,257 postmenopausal women over 45 years with periodontitis. Periodontitis contributes to inflammation and may enhance atherosclerosis. Digital panoramic radiographs are used to assess alveolar bone loss through the Progressive Rate Index (PRI). Carotid artery calcifications are also identified on panoramic radiographs and further confirmed through Doppler ultrasonography.
                                              Results reveal that patients with higher PRI values have more severe periodontitis and increased prevalence of CAC. Panoramic radiographs accurately predict CAC presence, as confirmed by ultrasonography. Sensitivity is 85.71%, and specificity is 100%. Identifying CAC through panoramic radiography prompts early intervention and prevention strategies.
                                              This research highlights the potential of panoramic radiographs in detecting CAC and predicting cardiovascular risks in postmenopausal women with periodontitis. The study underscores the importance of interdisciplinary collaboration between oral physicians and radiologists in identifying cardiovascular risks and prompting appropriate management. Further investigations could enhance the reliability of panoramic radiography in CAC identification.

                                              Keywords: Atherosclerosis, Menopause, Panoramic digital radiographs, Periodontitis.