International Journal of Medical Science and Dental Research

Volume 6 Issue 5 (September-October 2023)

    • Retrospective Evaluation of Immunomodulatory Agents’ Response and Side Effects In Relapsed and Refractory Multiple Myeloma Patients
      Objective: In this study, we aimed to determine the most appropriate approaches to shape our daily practice by revealing treatment responses, side effects and side effect management of relapsed and refractory multiple myeloma patients who were treated with immunomodulatory drugs(IMIDs).

      Method:This study was carried out among the patients with multiple myeloma who underwent IMIDs between June 2001 and September 2018. General characteristics, overall survival, response rates, side effects profiles, prophylaxis used to prevent side effects of IMIDs are evaluated.

      Results:The median age of 85 patients included in the study was 62 (38 – 83). Fifty (58.8%) of the patients were male. The mean follow-up period of the patients was 64 months Overall survival of the patients was 87 months (5.70; 75.83 - 98.18). Of the 85 patients included in the study, 11 received thalidomide, 78 received lenalidomide, and 15 received pomalidomide. While none of the patients receiving thalidomide was discontinued due to side effects, the dose was reduced in 1 (9.1%) patient. In 25 (32.1%) of the patients receiving lenalidomide, the drug was discontinued, while the dose was reduced in 21 (26.9%) patients. In 1 of the patients using pomalidomide, the drug was discontinued, and no dose reduction was made in any of the patients.

      Conclusion:IMIDs are drugs that are frequently used in RRMM and have a pronounced response. In order to use the drugs effectively, prophylactic approaches to prevent the side effects before they are developed should be determined according to patient characteristics.

      Keywords:: Relapsed and refractory multiple myeloma, immunomodulatory drugs (IMIDs), lenalidomide, thalidomide, pomalidomide, effect, side effect

    • Salivary Flow Rate, Ph Level, and Candida Colonization in Elderly Patient at Tuntungan Public Health Center, Sumatera Utara
      Abstract: Salivary flow rate and pH level are pivotal parameters influencing oral microbial equilibrium and defense mechanisms against pathogens, including Candida species. With advancing age, elderly individuals encounter physiological changes that often lead to decreased salivary flow and altered pH levels. These changes can potentially foster an environment conducive to Candida colonization and subsequent infections. The aim of this study is to investigate the potential correlation between salivary flow rate, pH levels, and the count of oral Candida colonies in elderly. Furthermore, the study aims to identify the Candida species present in the oral cavities of elderly individuals. This analytical cross-sectional study involved 105 elderly patients visiting Tuntungan Public Health Center, Sumatera Utara. Unstimulated saliva was collected by spitting method for 5 minutes to measure salivary flow rate and pH level. Subsequently, the samples were cultivated on Saboraud Citrus agar medium, and over a period of 24-48 hours, the development of Candida colonies was monitored, and their quantities were tallied. Identification of each Candida colony has been conducted using Vitek® 2 Compact system. Statistical analyses were performed to compare the salivary flow rate (SFR) and pH between male and female participants using T-test. The relationship between SFR and salivary pH level was examined using the Fisher Exact test. Additionally, Chi-Square tests were utilized to examine the relationship between SFR and pH level with the presence of Candida colonies. There are no differences found in the mean SFR (p=0.87) and salivary pH (p=0.18) between male and female groups. There was a significant relationship found between salivary flow rate (SFR) and salivary pH level (p<0.0001). There was a significant relationship found between candida colonization and SFR (p=0.03) but not with salivary pH level (p=0.53). In conclusion, the reduction in salivary flow rate may increase the risk of acidity and Candida infections in elderly patient's oral cavity and the most Candida species inhabiting elderly oral cavity is Candida albicans. Therefore, preventive measures should be taken to maintain good oral hygiene and overall health in elderly.

      Keywords: Salivary flow rate, pH level, Candida, Elderly.

    • Nutritional Status (BMI) Association with Anemia among Reproductive age Group of Women Attending Karnali Academic of Health Sciences, Jumla
      Introduction: Nutrition is a critical part of health and development. Better nutrition is related to improved infant, child, reproductive age group of women and maternal health. In the past few years, the issues of Reproductive Health have been increasingly perceived as social problems; they have emerged as a matter of increasing concern throughout the developed and developing countries. Nutritional status (BMI) and Anemia, in every form, presents significant threats to human health. Today the world faces a double burden of malnutrition that includes both under nutrition and overweight, especially in developing countries like Nepal.
      Methods: A prospective cross-sectional study was conducted among the reproductive age group women attending for needful treatment in Medical and Maternal OPD of Karnali Academic of Health Sciences, Jumla. A total of 210 reproductive age group women from were participated in this study. Before collecting the data, the consent was taken from the participants.Data were collected from a semi-structured questionnaire and analyze by using SPSS software (20.0 Version). A chi square test was used to show the relationship between BMI and anemia. For Haemoglobin measurement Sahli’s (Acid Haematin) method was used.
      Results: Out of 210 participated, most of the women are 20 to 28 years of age 86 (40.9%) and least on 40 to 49 years of age 20 (9.53%). Most of the participants are non-anemic 183(87.10%) and those who are in anemic 23(10.95%) falls under mild degree of anemia. The most of the age group are non-anemic in which age 20 to 29 years 131 (87.92%) and those who are anemic age more or equal to 30are the least anemic 2(8.34%)., it was found that there was no significant relationship (P>0.420).In the relationship of BMI with age group 30 to 39 years shows 13(8.73%) of obesity, 27(18.12%) of pre-obesity and 43(28.85%) were under weight, whereas age group less or equal to 29 years shows least degree of BMI 5(20.84%) obesity, 4(16.66%) pre-obesity and only 5(20.84%) falls under weight., it was found that there was no significant relationship (P>0.139). Similarly the relationship of anemia and BMI, 27 participant show the relationship of anemia and BMI in which 5(18.51%) obesity, 2 (7.42%) pre-obesity and 3(11.11%) falls under weight. Out of 183 non-anemic participant 15(18.20%) obesity, 38(20.77%) pre-obesity and 61(33.33%) under-weight where result found to be highly significant association of degree of anemia with BMI (P>0.006).
      Conclusion: The finding of this present study concluded that majority of the respondent were in 20 to 29 years of age 86 (40.9%) with non-anemic 183 (87.10%) and majorities anemic participants 23 (10.95%) falls under mild degree of anemia. The study also reveals that there is no significant relationship of anemia with the age and as relationship of nutrition status (BMI) with age of the respondents respectively (p- 6.420 and 0.139). But the relationship of anemia with the nutritional status (BMI) of the respondents was very highly significant (p-0.006).

      Keywords: BMI, Anemia, Reproductive Age group of Women, OPD, KAHS.

    • Could Crab Parameters Replace Serum Free Light Chains in the Follow-Up Of Multiple Myeloma?
      Abstract: Purpose: Multiple Myeloma (MM) is a plasma cell dyscrasia which is the second most common haematological malignancy.In our study, we aimed to compare the serum free light chain kappa and lambda tests, which are still frequently used for this purpose, with the biochemical parameters of the CRAB criteria.
      Method:A total of 50 MM patients who applied to the haematology clinic of Başkent University Medical Faculty Istanbul Hospital were included in the study.The sFLC-k, sFLC-l and K/L ratios, concurrent CRAB parameters at the time of initial diagnosis.
      Findings:When we compared the FLC values and rates at the time of diagnosis with the CRAB parameters, we observed that the increase in CRAB parameters was not at the same rate compared to the increased FLC values and therefore did not reflect the depth of the disease.
      Discussion:Although CRAB tests are mainly used at the time of diagnosis in MM, the characteristics of the tests do not appear to be useful in the follow-up of progression of MM, Despite the problems of interlaboratory standardisation, cost and lack of easy accessibility, we believe that sFLC values should still be considered as the most valuable test in the follow-up of MM.

      Keywords: Multiple Myeloma- Serum free light chains-Calcium-Creatine-Hemoglobin

    • Red Cell Distribution Width as a Prognostic Marker for Mortality in Critically Ill Patients Above 85
      Background: The increasing elderly population, particularly those aged ≥ 85 years, emphasizes the need for reliable prognostic markers to guide clinical decision-making in Intensive Care Units (ICUs).Existing scoring systems, such as the Acute Physiology and Chronic Health Evaluation (APACHE) and the Glasgow Coma Scale (GCS), have shown limitations in sensitivity and specificity when applied to geriatric demographics. This study aimed to evaluate Red Cell Distribution Width (RDW) as a potential prognostic marker for mortality outcomes in critically ill patients aged 85 years and above.
      Methods: This observational cohort study retrospectively analyzed the medical records of 489 patients aged ≥ 85 years who were admitted to the ICU of Mersin University Medical School, Turkey, between January 1, 2015, and December 31, 2022.This study assessed the association between RDW levels and mortality outcomes, controlled for demographic data, biochemical indices, and hematological markers. Statistical Package for the Social Sciences (SPSS) version 26 was used for data analysis.
      Results: Patients were stratified into two groups based on RDW levels: ≤ 15.5 (N=145) and > 15.5 (N=344). The mortality rate was significantly higher in the group with RDW > 15.5 group (67.7% vs. 51.7%; p < 0.001).Other variables, such as age, sex, and concurrent diseases, did not differ significantly between the two groups. Hematological parameters, such as hemoglobin and mean platelet volume (MPV), were found to be significantly different between the two groups (p=0.044 and p=0.016, respectively). Elevated levels of lactate dehydrogenase (LDH) were also noted in the RDW > 15.5 group (p=0.007).
      Conclusions: RDW appears to be an independent predictor of mortality in critically ill patients aged ≥ 85 years irrespective of other comorbidities. This study highlights the necessity to incorporate age-specific biomarkers such as RDW into clinical paradigms for geriatric critical care. Further research is warranted to explore the underlying mechanisms by which RDW modulates outcomes in this high-risk population.

      Clinical Application of the Study

      Early Risk Stratification: Our findings suggest that RDW may serve as an independent prognostic marker. Critically ill patients aged ≥ 85 years with elevated RDW levels may be identified as a high-risk group for mortality.

      Keywords: Red Cell Distribution Width (RDW); Critically Ill Patients; Geriatric Mortality; Prognostic Markers; Early Intervention; Risk Stratification

    • Outcomes of Adalimumab Biosimilar ABP 501 in Patients with Inflammatory Bowel Disease: Comparison of Adalimumab Naïve and Switching from Originator
      Background: In this study, we aimed to compare the effectiveness and safety of the ABP 501 molecule in inflammatory bowel disease patients who were ADA-naive and those who were switching from the originator molecule.
      Materials and Methods: Data was prospectively collected between March 2020, and October 2022. The outcomes of the study were therapeutic failure free remission, and therapeutic failure.
      Results: Seventy-four patients were analyzed for ABP 501-ADA naïve group (67.9% males; 9.4% biologics experienced; 69.8% CD; 30.2% UC) and ABP 501-ADA switch group (47.6% males; 14.3% biologics experienced; 85.7% CD; 14.3% UC). Median of total disease duration was 5.95 years (IQR 2.68-11.89), and follow-up time was 10.43 months (IQR 5.78-15.75). There was no significant difference between ABP 501-ADA naive and switch group respectively, in the rates of therapeutic failure free remission (86.8% vs. 90.5%) or therapeutic failure (13.2% vs. 9.5%), (p>0.05). There was no significant difference in terms of therapeutic failure-free survival between two groups (p=0.207).
      Conclusion: Results from this study showed no significant differences between ABP 501-ADA naïve and 501-ADA switch group in terms of therapeutic failure-free remission. Two groups were also found to be similar in terms of the therapeutic failure-free survival.

    • Anatomy Education in Nigeria: the Viewpoints of Medical Students
      Background: Anatomy course is essential in medical training. Adequate knowledge of anatomy is indispensable in diagnosis, interpretation of radiological investigations and safe treatment of patients. There are several debates concerning the methods of teaching anatomy. These arguments involve dissection and its significance, best methods of teaching and learning anatomy, time allocated to teaching anatomy and the nature of anatomy curriculum. The aim of this study is to assess perceptions of medical students on Anatomy, its methods of teaching, learning and assessment. MATERIALS AND METHOD Validated self-administered questionnaires were used. A total of 163 students of 200 and 300 levels voluntarily participated. RESULTS Majority of the students (more than four-fifth) enjoy anatomy course and they agree that adequate knowledge of anatomy is indispensable in becoming a good doctor (57.1%). Only 28.2% of respondents are willing to consider anatomy as a career. This is an increase to previous reports in Nigeria where only 1.5% among preclinical and 6.2% clinical among clinical students were willing to take a career in anatomy. Overwhelming majority of the respondents believe that dissection sessions are important avenues of teaching and learning anatomy. However, despite the popularity of the internet with students, only 39.9% of the students use it as a tool in learning and understanding anatomy. 93.3% of the respondents agree that the newly introduced mentoring programme in the department is very helpful in their learning and understanding of anatomy. CONCLUSION Anatomy still remains an important subject in medical training. Dissection is an important avenue of learning and teaching anatomy. RECOMMENDATIONS: There is need to increase students’ interest in career in anatomy by providing mentoring programmes in Anatomy departments. Students should be encouraged to embrace new methods of learning anatomy.

      Keywords: Anatomy, Education, Medical, Students, Dissection

    • Acellular Dermal Matrix Augmented Peri-Implant Mucosa: A Histological Analysis
      An essential component for the success of dental implants is adequacy of keratinized tissue. Autografts have been used successfully to augment deficient keratinised mucosa around implant with predictable results but additionally require surgical intervention at donor site. Acellular Dermal Matrix (ADM) provides an alternative treatment option while negating the disadvantages associated with additional surgical site. A grafted tissue or material undergoes transformation during wound healing and this can be best evaluated histologically. In this case report, we evaluated an ADM augmented peri implant mucosa site at 6-months interval to assess the soft tissue healing and its composition prior to implant loading. The acellular dermal graft site showed keratinised mucosa and connective tissue evidence of elastin fibres and various cellular (predominantly fibroblasts) and vascular elements.

      Keywords: Acellular Dermal Matrix, Graft, Dermacell

    • Stress and Depression among Dental Students at Loma Linda University: A Descriptive Study
      Purpose: The stress experience in dental school high. Every year students face academic and clinical challenges and the relative levels of these perceived stressors and potentially associated depression are not well established. The goal of this study is to describe dental students’ perceived stress and depression levels, and additionally, compares stress and depression levels across demographically-defined groups. Methods: Three hundred and eighteen dental students at Loma Linda University participated in a descriptive, cross-sectional study in the Fall of 2015. Perceived stress and depression were assessed using validated self-report questionnaires. Descriptive and mean comparison tests were performed to compare differences. Results: The response rate for the study was 75%, with a majority of respondents being male. Stress levels were moderate (Dental Environment Scale 66.4 ± 17.3), depression levels were low (Center for Epidemiological Studies Depression Scale Revised 12.1 ± 11.0). Females had higher levels of stress and depression than males. Conclusion: Stress experienced at dental school is most notable during clinical years, and varies meaningfully by group. Depression follows similar trends.

      Keywords: Depression, Female, Male, Students, Surveys and Questionnaires, Universities

    • Chronic Addiction to Tobacco: a Case of Successful de-addiction Using Yoga Prana Vidya (YPV) System Protocols
      Introduction: Consuming Tobacco in any form increases the chance of developing some chronic diseases, including cancer, lung illness, cardiovascular disease, and stroke. Giving off any form of tobacco has virtually instant positive effects. De-addiction is the process of getting rid of an individual's unending dependency on consuming certain harmful things. Though there are some medical treatments for the cessation of tobacco addiction, drugless treatments are always preferable. This paper presents a case of effective cessation of tobacco addiction using a drugless YPV system of energy healing. Method: The case study method is used in this paper by collecting information on the patient's addiction and medical history, YPV healer’s records, and patient feedback communications. Results: During the first week of healing, the patient's addiction was decreased by 50% of the previous level. The second week of recovery saw an additional 20% reduction. At the conclusion of the fourth week, the addiction rate was 10%. By the end of the third month, addiction had significantly decreased by 95%. After six months of the YPV healing intervention, the craving for tobacco fully halted, with no signs of relapse. Conclusions: As an Integrated and holistic system, YPV protocols have been established as very effective means of de-addiction. Further research is recommended. It is considered beneficial for frontline healthcare workers to acquire a working knowledge of the YPV healing practices to complement their respective specialties.

      Keywords: Tobacco Addiction, De-addiction, Rehabilitation, Yoga Prana Vidya System ®, YPV®

    • Peritonitis Due to Intestine Perforation and Appendicitis in Children with tyfoid Fever
      Children account for more than 50% of all cases of intestinal perforation in typhoid fever, but acute appendicitis as a rare complication of Salmonella Typhi infection. Case: A 4 years-old boy was admitted to the hospital with the chief complaints of fever, diffused abdominal pain, and abdominal distension. IgM Salmonella showed positive 10. X-ray of the abdomen revealed pneumoperitoneum. When, emergency laparotomy surgery, discovered the appendix was swollen and red. Conclusion This case showed that there was a relationship of Salmonella Typhi infection with acute appendicitis and intestinal perforation causing peritonitis

      Keywords:intestinal perforation, appendicitis, Salmonella Typhi,typhoid fever

    • The Effect of Oral and Dental Health Literacy on Quality of Life in Pregnant Women
      Abstract: This study was conducted to determine the effect of oral health literacy on the quality of life of pregnant women. The sample of this descriptive study consisted of 212 pregnant women. The data collection form consisted of Descriptive Information Form, Comprehensive Oral and Dental Health Knowledge Measurement Tool, Multidimensional Oral Health Locus of Control Scale and Oral Health Related Quality of Life Scale. The data were collected at the pregnancy school by face-to-face interview method. SPSS software was used for statistical analysis of the data and descriptive tests and nonparametric statistical tests were used. The mean age of the participants was 27.58±4.94 and 76.9% of them resided in the city centre. It was found that there was a statistically significant difference between the scores of the participants according to variables such as income status and giving importance to oral health (p<0.05). The total mean scores of the scales used in the study were found to be moderate. It was observed that oral and dental health literacy of pregnant women did not have any effect on quality of life.

      Keywords: Oral health, Oral and Dental Health Literacy, Oral health during pregnancy, Oral and dental health Quality of life Pregnancy, Quality of life

    • Case Report: A tuberculosis spondylitis pediatric patient with paraplegic
      Skeletal tuberculosis (TB) accounts for approximately 10% of all extrapulmonary TB with the spine as the most common skeletal site affected. Spinal tuberculosis accounts for almost 50% cases of skeletal TB. Thoracolumbar junction remains to be the most affected region. Case : A 3-years old and 2 months old girl was admitted to the hospital with the chief complaints of paraparesis, inability to walk for 3 months and back pain. X-ray of the lumbosacral revealed spondylitis TB. The patient was planned to undergo surgery due to neurological deficit secondary to spinal destruction. Conclusion This case showed that there was a relationship of Tuberculous spondylitis causing Paraplegia

      Keywords: Tuberculosis, Spondylitis, Paraplegia, Pott disease, Mycobacterium Tuberculosis

    • Phytochemicals in Medicinal Plants in Wound Healing
      Phytochemicals, natural compounds found in medicinal plants, play an important role in wound healing. This bioactive substance has been studied extensively for its therapeutic properties and is increasingly recognized for its potential to promote the healing process. Natural Medicinal Products for Wound Healing medicinal plants and their extracts have a long history of use in wound healing. They have been used as a topical application to facilitate wound healing. Research shows that this natural product contains phytochemicals that contribute to its healing properties. Structure of Bioactive Phytochemicals, research emphasizes the structure of key bioactive phytochemicals involved in wound healing. This compound is of particular interest because of its potential to speed up the healing process. Wound Healing Medicinal Plants various medicinal plants have been identified for their effectiveness in wound healing. This plant and its phytochemical components have shown promising results in aiding the closure of deep, full-thickness, and partial-thickness wounds. Phytochemicals found in medicinal plants offer a natural and promising approach to wound healing. Its therapeutic potential is rooted in centuries of traditional use and supported by contemporary research. Further exploration of these compounds may lead to the development of innovative wound treatments

      Keywords: wound healing, phytochemicals, medicinal plants

    • Types of Ulcerative Colitis, Pathogenesis of Ulcerative Colitis, Diagnosis of Ulcerative Colitis, Differential Diagnosis of Ulcerative Colitis and Treatment of Ulcerative Colitis
      Ulcerative colitis (UC) is a chronic inflammatory bowel disease manifested by inflammation and ulceration of the mucosal lining of the colon and rectum. It is a multifactorial disorder that affects millions of people worldwide, causing significant morbidity and impairing the quality of life of patients. This review article aims to provide an in-depth analysis of the pathogenesis, clinical features, diagnosis, and treatment options available for ulcerative colitis. Through an extensive examination of current literature, we provide the information regarding understanding of the disease to aid doctors in managing UC effectively.

      Keywords: Ulceration of the mucosal lining of the colon as well as rectum, abdominal pain, rectal bleeding, weight loss, inflammation, ulcerative proctitis, proctosigmoiditis, trctal bleeding, tenesmus, bloody diarrhea, weight loss, fever, fatifue, abnormal immune response, dysbiosis, erythema nodosum, pyoderma, gangrenosum, sigmoidoscopy, CT angiography, colorectal cancer and ileosyomy.

    • The relationship between Smoking and DMFT Index Scores and Tooth Loss
      We aimed to investigate the relationship between smoking, periodontal diseases, and tooth loss. The smoking features scores of 248 patients who presented to the Ondukuz Mayıs Faculty of Dentistry between 10.03.2020 and 01.10.2020 were investigated. All participants’ oral hygiene behavior and practices, oral medical history, and dental visits were also investigated. Decayed, Missing, and Filled Teeth (DMFT) index scores were calculated following oral examination and radiography. The mean age of the participants was 38.42±14.46 years, and 116 (44.4%) smoked every day. Mean numbers of missing teeth were higher among smokers than non-smokers (4.14±0.8 vs 3.06±0.9, respectively p<0.001), as were mean DMTF scores (11.27±6.14 vs 8.23±5.76, respectively p<0.001). The number of missing teeth and DMFT scores increased with the number of cigarettes smoked per day (r=0.288 and r=0.347), pack-years (r=0.436 and r=0.326), and Fagerström Test for Nicotine Dependence (FTND) scores (r=0.298 and r=0.329, respectively) (p<0.05 for all). Linear regression analysis showed that 61% of the change in the number of missing teeth can be explained by the independent variables of age (95%CI, OR=0.004-0.291), number of cigarettes consumed a day (95%CI, OR=0.967-3.457), pack-years (95%CI, OR=-0.131-0.049), FNDT score (95%CI, OR=0.199-1.427), and frequency of tooth brushing (95%CI, OR=-7.378—1.296). Our results indicate the frequency and intensity of smoking have a significant association with DMFT scores and the number of missing teeth

      Keywords: DMFT Index, Fagerström Nicotine Dependence Test, Smoking, Tooth loss,

      • Exploring the Impact of Socio-Economic, Political And Cultural Factors Affecting Uptake of National Health Insurance Programs in Nigeria
        Healthcare systems must be affordable, available and accessible to achieve the universal healthcare mantra. A vital element for obtaining affordable, universal healthcare is the National Health Insurance Scheme (NHIS), which also provides a means of avoiding financial difficulty when accessing medical care. Only 5% of Nigeria's population of about 200 million has health insurance, and the vast majority still pay for medical care out of their pockets. This article examines how social, political, and cultural factors affect Nigeria's adoption of the National Health Insurance Scheme (NHIS). By carefully examining factors encouraging or discouraging adoption, this article highlights the essential aspects affecting the adoption of NHIS. It concentrates on socio-economic concerns, including income levels and insurance costs. Premiums, education, health literacy, and differences between urban and rural populations' access to healthcare. Political aspects, such as government support, stakeholder engagement, and institutional capacity, are examined alongside cultural factors encompassing traditional beliefs, trust in healthcare and insurance providers, and the impact of social norms. Additionally, highlights key drivers and hindrances of adoption, including successful implementation strategies, positive health outcomes, and financial protection. Identifying specific challenges faced and barriers to enrollment and utilization. Finally, this study provides policy implications and recommendations, emphasizing the need to strengthen socio-economic support mechanisms, enhance political commitment and governance, and adopt culturally sensitive approaches to promote NHIS adoption. Acknowledging these factors is essential for the successful implementation of NHIS in Nigeria.

        Keywords: National Health Insurance Scheme, Socio-economic factors, political factors, cultural factors, National Health Insurance Programs

      • Intrigue Below the Tongue: Triumph Over Floor of Mouth Schwannoma
        Schwannomas are benign tumors arising solely from schwann cells, usually presenting as asymptomatic painless mass. They are rare in the oral cavity, where the most commonly affected site is the tongue. We are presenting a case report of a middle-aged male patient with a four-year history of painless mass in the floor of mouth diagnosed as schwannoma post operatively.

        Keywords: Schwannoma, Floor Of Mouth Tumor, Trans Oral Excision

      • How Do We Better Control Periodontal Plaques and Alveolar Pyorrhoea for A Subjection of Oral Bacteria-Related Systemic Diseases?
        Periodontal disease eventually causes tooth loss due to alveolar pyorrhoea, and in recent years, systemic diseases, such as Alzheimer's disease and type 2 diabetes, caused by oral bacteria have attracted much attention. Porphyromonas gingivalis has also been reported to cause Alzheimer's disease. However, periodontal disease remains a major problem in humans. In recent years, the bactericidal power of ozone has attracted attention because palmoplantar pustulosis, which is thought to be caused by oral bacteria, exerts a therapeutic effect when sterilized with ozone water. Irrigation with ozone saline solution is believed to be effective in treating periodontal abscesses. However, periodontal disease cannot be completely cured with this treatment, and oral bacteria that are resistant to ozone oxidation exist. Furthermore, P. gingivalis has an oxidation-resistant structure. Therefore, preventive measures are required before the onset of P. gingivalis-induced Alzheimer's disease. Under these circumstances, the removal of dental plaque is not always easy; therefore, high-pressure washing has been proposed, UV (ultraviolet) light treatment has been attempted for gingivitis, and ultraviolet-A (UVA) light has also been suggested as an application for the geographic tongue, which is suggested to involve bacteria. Here, we discuss the applicability of new therapeutic strategies for oral diseases caused by oral bacteria.

        Keywords: Oral bacteria, Systemic diseases, Palmoplantar pustulosis, Ozone nanobubble water, Oral care

      • The Relationship of Thyroid Hormone Levels (FT4-THSs) with Ferritin Levels in Thalassemia Patients
        Introduction: Thalassemia patients often experience anemia and require repeated transfusions. Repeated transfusions will result in a buildup of iron in the body which will cause dysfunction of the body's organs, including the thyroid gland. Ferritin is the major iron storage protein and is essential for iron homeostasis. This study aim to know the relationship between increased ferritin levels and thyroid hormone disorders in thalassemia patients.Method: A cross-sectional study conduct at Pediatric Departement, Wahidin Sudirohusodo Hospital in March - July 2023. Thalassemia patient who met inclusion criteria was measured ferritin, FT4, and TSHs level. The relationship between ferritin and thyroid hormone disorders was analyzed.
        Results:A total of 39 subjects. The mean age was 10,5 years. There was no relationship between FT4 and ferritin (p = 0,98). There was no relationship between TSHs and ferritin (p = 1,00), and there was no relationship between ferritin levels and thyroid hormone disorders in children with thalassemia (p = 0,94). The ferritin cut-off was 1154 ng/mL, but cannot be used as a reference for thyroid hormone disorders in thalassemia patients.
        Conclusion:There was no significant relationship between thyroid hormone levels and ferritin levels in children with thalassemia who underwent repeated transfusions.

        Keywords: Children, Ferritin, FT4, Thalassemia,Thyroid hormone,TSHs

      • Renal Artery Pseudoaneurysm after Extracorporeal Shockwave Lithotripsy- Literature Review
        Extracorporeal shock wave lithotripsy (ESWL) is a very effective treatment for kidney stones, although not free of complications. PAARs are rare vascular complications, little described in the literature, present in less than 1% of patients with hematoma after ESWL. Rupture of the PAAR has a high mortality rate and its management must be carefully elaborated. The diagnosis of this vascular lesion is a challenge, since the clinical and laboratory manifestations are not specific and may require additional tests. In this study, we reviewed the current literature relating PAAR after ESWL.

        Keywords: Aneurysm, False; Conservative Treatment; Extracorporeal shock wave lithotripsy; Renal Artery

      • Pleomorphic Lobular Carcinoma in Situ: Issues in the surgical management
        Background :Lobular carcinoma in situ (LCIS) is considered a risk marker for invasive breast cancer with no requirement for surgical excision, while ductal carcinoma in situ (DCIS) is a precursor of invasive disease,demanding breast surgery and adjuvant treatment.Pleomorphic LCIS is a rarehistological subtype that presents a different pattern of clinical outcome compared to classic LCIS, due to frequent association with invasive disease and high recurrence in case of positive surgical margins. Considering this contrast, although there is no sufficient literature support to determine an optimal treatment, in clinical practice the tendence is to managePLCISsimilarly to DCIS, including with regard to surgical excision and adequate margins.Methods:Biomedical literature search on PubMed using terms „pleomorphic‟ and „lobular carcinoma in situ‟ in the articles titles of the past 10 years.Conclusion: Although there is still nosetted guidelines for PLCIS management, this lesion isconsidered more aggressive than classic LCIS demanding different approuch. To define the standard guidance that brings safety outcome to the patient presenting this disease, prospective studies and meta-analysis, including precise surgical margin information is necessary.

        Keywords: Carcinoma in situ, Management, Pleomorphic, Surgical treatment

      • Chronic Inflammation Parameters and Treatment Duration: Implications for Cervical Cancer Survival
        Cervical cancer remains a major global health problem requiring precise prognostic markers to improve patient outcomes. This retrospective study investigates the complex relationship between chronic inflammation parameters, treatment duration and survival outcomes in cervical cancer. While traditional markers like C-reactive protein, lactate dehydrogenase, albumin, Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, lymphocyte-monocyte ratio, CRP-albumin ratio didn't directly impact Disease-Free Survival (DFS) and Overall Survival (OS), an intriguing association emerged with treatment duration. Elevated Neutrophil-to-Lymphocyte Ratio (NLR) correlated with prolonged treatment, revealing a critical threshold of 65 days. Treatment durations ≥65 days led to a significant 2.62-fold (p=0.041) decrease in DFS and 3.74-fold (p=0.04) decrease in OS. These findings underscore the critical need for a comprehensive approach, integrating inflammation markers and treatment duration, to optimize personalized interventions in cervical cancer, potentially reshaping future therapeutic strategies for improved patient outcomes.

        Keywords: Cervical cancer, concurrent chemoradiotherapy, haemato-immunological indicators, total treatment duration

      • Exercise using Elastic Bands Affects Balance Function, Flexibility, Risk of Elderly Falling
        Physical decline occurs in the form of changes in the musculoskeletal system, which affects the decrease in muscle strength, resulting in slow movements, a tendency for unstable legs, and a decrease in the ability to anticipate slipping, tripping, and slow responses, thereby increasing the risk of falls in the elderly. This study is a Quasi Experiment with a Pretest-Posttest with One Group Design. The research was conducted from April to September 2019 at GMIM Sion Malalayang Manado. The subjects of this study were individuals aged ≥ 60-75 years who did not have problems with cognitive and communication abilities and had the ability to live independently. They were selected through a selection process and agreed to participate in the study after an interview. There is an influence of physical exercise using an elastic band, as measured by TUGT, FSST, and CRST, on body balance, fall risk, and body flexibility in the elderly.

        Keywords: body balance; exercise; muscule

      • Comparison of Anatomical Structures in Trigonum Anale-Trigonum Urogenitale in Postpartum and Nulliparous Patients
        There are many studies in the literature on pelvic anatomy and morphometry using MRI. Pelvic anatomy and the interrelationship of the structures here are extremely important for conditions such as urinary incontinence, pelvic organ prolapse, pelvic floor weakness and dictocia. In this study, the organs in the anal and genital trigone regions on the outer side of the pelvic floor were examined. Because the morphometry of the pelvis and the relationship and morphometry of the external genital, urinary and anal organs in the pelvic floor are as important as the inside of the pelvis. In the study, two groups of patients were determined: patients who had never given birth and patients who had given birth at least once. In the distance measurements of the organs in the pelvic floor, the tuber ischiadicum, a bony structure, was defined as a guide point. In measurement results, the distance between the right tuber ischiadicum and the lower border of the vagina is highly significant when comparing patients who have given birth and those who have not given birth (p=0.035). In addition, the distance between the left side tuber ischiadicum and the lower border of the vagina was found to be highly significant in both patient groups (p = 0.019).

        Keywords: Female pelvic floor morphometry, Trigonum anale, Trigonum urogenitale, Nulliparous

      • Evaluation of the Fixation Effect of Modified Larssen, Klotz, Formalin 10% and Saturated Sall Solutions on Heart Tissue
        By evaluating the fixation effect of Modified Larssen (MLS), Klotz (KLO), Formalin 10% (FA) and Saturated Sall (SSS) solutions on heart tissue, it was aimed to determine a suitable solution for cadaver embalming. The solutions were prepared with the knowledge of the literature. The heart organs were photographed freshly with a millimetric scale on them. Three months later, the heart organs were removed from the solutions, a millimetric scale was placed on them again and they were photographed. In addition, the solutions were examined microbiologically every week. Three months later, after photographs were taken, histological examination was performed on sections taken from four heart tissues. As a result of color measurements, it was observed that the color was preserved best in MLS solution. In histological examination, it was determined that cell and tissue integrity was best preserved in FA solution. But KLO solution also gave results close to FA solution in histological examination. In the microbial analysis, unfurtunately MLS solution is the only solution in which microbial growth occurs. On the other hand, Klotz, SSS and FA solutions are resistant to microbial growth at room temperature for 3 months. Cadaver embalming solutions are becoming more and more important day by day. The study can be included in the literature as an important study in terms of comparing many different properties (color, histological and microbial analysis) of MLS, KLO, SSS and FA solutions

        Keywords: Cadaver Embalming, Modified Larssen, Klotz, Saturated Sall Solution, Formalin 10%

      • Herpes Zoster Infection: Effective Management Using Yoga Prana Vidya Healing Protocols
        Introduction: Herpes infections have been acknowledged in disease concepts since ancient times. Medical science has progressed and has produced comprehensive information on herpes viruses, and efficient treatments are now available including complementary and alternative medicines (CAM) such as Yoga Prana Vidya System. Various methods for preventing virus reactivation and virus latency are under research. This paper presents a case of the Herpes Zoster (HZ) of a 19-year-old girl treated with Yoga Prana Vidya System protocols.
        Method: This paper uses the case study method going through the patient’s medical records, the YPV healer’s records of the intervention, and the patient’s feedback. The patient was undergoing medical treatment, and the YPV healer conducted a YPV intervention as complementary medicine.
        Results: A significant reduction in pain in the affected area occurred from the fourth day of YPV healing. By the 10th day, the patient recovered from the pain completely. The patient felt very cheerful and happy with the results.
        Conclusions: YPV framework conventions, with practically little or no utilization of medications or contact, have been demonstrated to work effectively in decreasing different sorts of pain with a speedy recovery, and the results of this study are one such example. YPV Healing treatment has additionally been found to offer solutions to cure different sicknesses as complementary and alternative medication by treating the underlying causes comprehensively. A course educational plan of the YPV Healing treatment framework might be considered for clinical, nursing, and veterinary training. Further Scientific examination is suggested.

        Keywords: Herpes Zoster Virus, Post Herpetic neuralgia, Yoga Prana Vidya System®, YPV®