Horizontally root fractured teeth with pulpal vitality - two case reports

This case study reports the successful outcome of horizontal root fractures of two different patients, which took place in permanent incisors. Report 1 describes a case of a 29-year-old patient who suffered a mandibular trauma affecting mainly the lower central incisors, caused by a car accident. A panoramic radiograph was taken right after the accident and showed a horizontal root fracture in the middle third of tooth 42, which went untreated. Report 2 illustrates a case of a 17-year-old male patient who searched for orthodontic therapy and the periapical radiograph showed horizontal root fracture in tooth 11 caused by a previous trauma, which went untreated as well. There was healing through the reestablishment of pulp activity and dental coloration without professional intervention.     

Fully endoscopic stapes surgery (stapedotomy): technique and preliminary results

Stapedotomies are perfomed with the aid of surgical microscopes. However, the microscope has some limitations and may cause complications such as damage to the chorda tympani nerve. There are just a few cases and no series published on the use of sino-nasal endoscopes in stapedotomies.Objectivesa) To investigate the feasibility of using sino-nasal endoscopes in stapedotomies, focusing on the visualization of important structures. b) To show initial results, discuss possible advantages and disadvantages of this instrument.Methods15 patients with otosclerosis were selected to undergo stapedotomies in 2010. The data and surgery videos were analyzed retrospectively (study case series). The anatomical conditions of the oval window niche and surgical steps were described and used to assess possible benefits of such procedures.ResultsThe surgeries were performed with endoscopes only and all relevant anatomical structures were visualized without difficulty. No complications were observed and 14 of the 15 patients reported improvement of their hearing, confirmed by postoperative audiological tests.ConclusionTotally endoscopic stapes surgeries are technically feasible, safe and promising. In this small series, the main advantages were: virtually no trauma to the chorda tympani nerve and excellent vision. The disadvantages were the lack of stereoscopic vision, having to work with one hand only and the learning curve.     

Effect of Interferential Current Stimulation in Management of Osteo-arthritic Knee Pain

The primary purpose of this study was to assess the effect of interferential current stimulation on osteo-arthritic knee pain in the black Nigerian population.Thirty patients with a history of not less than three months' knee pain with radiographic confirmation of osteo-arthritis took part in the study. Patients were allocated alternately into an interferential current stimulation group and a placebo group.All the patients participated in a baseline exercise therapy programme with dietary advice. They received a total of eight 20-minute treatment sessions in four weeks. The treatment group received interferential current stimulation at a frequency of 100 Hz and pulse length of one-thirtieth of a second for the first 15 minutes of their treatment session. The stimulus was then reduced to 80 Hz for the next five minutes while other parameters remained unchanged. For the placebo group the electrodes of the stimulator were positioned appropriately but the stimulator was not tuned.The analysis of variance demonstrated a significant result (P < 0.01). Post hoc analysis revealed differences between initial and final pain values in the interferential current stimulation group. Similar results were observed in the placebo group, but the pain rating in the interferential current stimulation group was found to be significantly better than that for the placebo group.It was concluded that interferential current stimulation is more effective than a placebo in relieving osteo-arthritic knee pain in black Nigerian patients with symptomatic hypermobility.     

Interconception Care for Women With Prior Gestational Diabetes Mellitus

The diagnosis of gestational diabetes mellitus (GDM) signals greater pregnancy risk but also increased lifelong risk of developing diabetes and cardiovascular disease. In women with GDM, insulin resistance exceeds that observed in normal pregnancy and to varying degrees may persist or worsen after birth. Therefore, during postpartum and interconception periods, women with a history of GDM must be monitored for manifestations of increasing insulin resistance, hyperglycemia, dyslipidemia, hypertension, and increased adiposity. Care of women with prior GDM in the postpartum and interconception periods affords clinicians a unique opportunity for targeted screening and health promotion. The objective of this review was to synthesize evidence related to interconception care for women following a pregnancy complicated by GDM and to suggest principles of care: 1) case finding and multiple patient/clinician reminders for women with prior GDM are necessary so that screening occurs in the postpartum through interconception periods; 2) monitoring of metabolic (glucose) and cardiovascular risk (lipids, blood pressure, adiposity) should occur at regular intervals and more often in women with additional risk factors such as insulin use during pregnancy, early diagnosis of GDM, obesity, prediabetes, and dyslipidemia; 3) breastfeeding and use of long‐term contraception should be encouraged; and 4) lifestyle modifications that are effective in preventing and delaying disease should be encouraged.     

Mitochondrial haplogroup is associated with the phenotype of familial amyloidosis with polyneuropathy in Swedish and French patients

Familial amyloidotic polyneuropathy (FAP) is a monogenic disease caused by mutations in the transthyretin ( TTR ) gene. The phenotype of the most common TTR mutation, V30M, varies within and between populations. Oxidative stress and protein misfolding are cellular processes involved in the development of FAP. Because the mitochondria are important for both these processes, we investigated if mitochondrial haplogroups are related to age at onset of the disease in Swedish and French FAP patients. Mitochondrial haplogroup analysis was performed on 25 early-onset (below 40 years) and 29 late-onset (above 51 years) Swedish FAP patients. DNA from 249 Swedish individuals served as controls. In addition, 6 early-onset and 17 late-onset French FAP patients were examined with 25 French controls. The haplogroup distribution among late-onset Swedish and French cases was similar to that found in the general populations, whereas among early-onset cases a different haplogroup distribution was seen. The relatively rare haplogroup K was significantly more common among early-onset cases. Our findings substantiate the suggestion that a genetic component, still to be found, affecting mitochondrial function has an impact on the amyloid generating process in transthyretin amyloidosis.     

应用分子生物学技术产前诊断Down综合征

目的 探讨应用PCR分子生物学方法产前诊断Down综合征（Down syndrome,DS)。方法 取产前诊断病例：羊水100例，绒毛16例。提取DNA，PCR扩增21号染色体的6个多态位点，电泳，膜转移，等位基因位点分析，诊断。结果 正常人为两种带型：杂合型显示两条带，纯合型一条带。Down综合征患者为三种带型：完全杂合型显示三条带，半杂合型两条带（信号增强的2：1带），纯合型一条带。100例羊水中2例阳性，16例绒毛标本中1例阳性，3例患者，至少有2个位点检出三个等 基因，患者为2个位点时，表现2：1带型；无一例正常检出三个等位基因。所有结果均与细胞染色体核型检查相符。结论 本分子生物学方法产前诊断DS简便、快速、可行，是一种值得推广的方法。     

Hand hygiene practices among community Health Officers in Rivers State,Nigeria

Background

Health care associated infections are most commonly transmitted by the hands of Health care workers and other hospital personnel.

Objective

To investigate compliance with hand hygiene guidelines and methods of hand hygiene practice among community health officers in Rivers State Nigeria.

Methods

Self administered questionnaires were distributed to 68 community health officers. The questionnaires consisted of 19 items which contained information on bio-demographic characteristics and hand hygiene practices. Data were analysed using SPSS-16 statistical software. Proportions were compared using Chi- square test and ‘p’ value less than 0.05 was considered statistically significant.

Results

The response rate was 97.1%. There were 11 (16.7%) males and 55 (83.3%) females with a male to female ratio of 1: 5. The age of the participants ranged from 28–56 years with a mean age of 39.7±6.7. Washing of hands before and after contact with patient was 60.1% and 97% respectively. The difference was significant (p<0.01). Allergy to gloves was 15.2%. About three-quarter (77.3%) of the workers used soap and water to wash the hands when soiled or visibly contaminated. None of the workers used alcohol hand rub.

Conclusion

Though there was improved compliance to hand hygiene guidelines, this still fall short of acceptable standards. The provision and promotion of the proper use of alcohol-based hand rub may further improve compliance with hand hygiene by reducing the time required to perform it and the convenience of the method.