The outcome of Manchester–Fotergill operation for uterine decensus repair: a single center experience

Purpose

The aim of this study was to evaluate the clinical characteristics, peri- and post-operative outcomes, and clinical effectiveness of the Manchester–Fothergill (MF) procedure for uterine descensus as a uterine-sparing surgery.

Methods

In this study, 49 patients underwent the MF procedure as a uterine-sparing surgery for uterine descensus during 2008–2012 in the Department of Urogynecology at Kanuni Sultan Süleyman Research and Teaching Hospital, Istanbul, Turkey.

Results

Medical records and follow-up data were collected from 24 of the 49 patients (48.9 %). The mean age was 49.3 ± 9.1 years, and parity 3.6 ± 1.5; 41.6 % were post-menopausal; 6 patients (25 %) had grade II, and 18 (75 %) had grade III uterine prolapse; 95.8 % had associated cystoceles, and 79.1 % had associated rectoceles; 66.6 % complained of urinary incontinence. On follow-up examination, the cervical stumps were satisfactorily situated in 23 of 24 patients, and recurrent prolapse was seen in 1 patient (4.1 %). Bladder perforation was repaired at the time of the operation in 1 patient, and one complained of post-operative urinary retention.

Conclusion

The MF procedure is a viable option to surgically correct uterine descent while preserving the uterus to treat recurrent prolapse with a low complication rate and low morbidity.     

Clinical evaluation of different posterior resin composite materials: a 7-year report.

OBJECTIVES: The aim of this study was to investigate the clinical performance of 120 posterior composite restorations placed in 38 patients after a period of 7 years. METHOD AND MATERIALS: Eighty-eight Class I and 32 Class II restorations were made (93 molars and 27 premolars) using three different resin composite materials: Z100, Clearfil Ray-Posterior, and Prisma TPH. The restorations were evaluated using Ryge's criteria for color match, marginal discoloration, marginal adaptation, secondary caries, surface texture, and anatomic form at baseline, 1,2, 5, and 7 years. Photographs and radiographs were taken at each recall period. RESULTS: At 7-year recalls, 70 restorations were available for examination. Four restorations had failed due to secondary caries. Saliva sampling was performed to determine the level of mutans streptococci and lactobacilli for the four failed restorations at the last recall. No statistically significant differences were found among the materials in regard to color match, anatomic form, and secondary caries. Clearfil Ray-Posterior had statistically significantly rougher surface texture than the surrounding enamel compared to the other resin composites. Z100 showed more cavosurface margin discoloration after 5 years than the other two resin composites. All materials had slight marginal adaptation problems at the 7-year recall. There was no apparent relationship between the levels of mutans streptococci and lactobacilli in saliva and the failed restorations. CONCLUSION: The three posterior composites tested had acceptable clinical performance after 7 years.     

Codon-54 polymorphism of the fatty acid-binding protein 2 gene is associated with elevation of fasting and postprandial triglyceride in type 2 diabetes

Patients with type 2 diabetes are frequently dyslipidemic or hypertriglyceridemic. To assess whether increased intestinal triglyceride input leads to elevated fasting and postprandial triglycerides in type 2 diabetes, we used the codon 54 polymorphism of the fatty acid-binding protein 2 gene, which results in the substitution of threonine (Thr) for alanine and is associated with increased intestinal input of triglyceride. Of the 287 diabetic patients screened, 108 (37.6%) were heterozygous and 31 (10.8%) were homozygous for the Thr-54 allele. Mean (+/-SEM) fasting plasma triglyceride levels in patients with the wild-type (n = 80), those heterozygous for the Thr-54 allele (n = 57), and those homozygous for it (n = 18) were 2.0 +/- 0.09, 2.7 +/- 0.20, and 3.8 +/- 0.43 mmol/L, respectively. A linear relationship of mean fasting plasma triglyceride levels (r2 = 0.97) between the 3 groups was found. After fat ingestion, the postprandial area under the curve of plasma triglyceride (P = 0.025) and chylomicrons (Sf > 400, P = 0.013) was higher in the Thr-54/Thr-54 (n = 6) than in the wild-type (n = 9). Our results are consistent with the hypothesis that, in type 2 diabetes, increased intestinal input of triglyceride can lead to elevated fasting and postprandial plasma triglycerides.     

Nanowall Textured Hydrophobic Surfaces and Liquid Droplet Impact

Water droplet impact on nanowires/nanowalls’ textured hydrophobic silicon surfaces was examined by assessing the influence of texture on the droplet impact dynamics. Silicon wafer surfaces were treated, resulting in closely packed nanowire/nanowall textures with an average spacing and height of 130 nm and 10.45 μm, respectively. The top surfaces of the nanowires/nanowalls were hydrophobized through the deposition of functionalized silica nanoparticles, resulting in a droplet contact angle of 158° ± 2° with a hysteresis of 4° ± 1°. A high-speed camera was utilized to monitor the impacting droplets on hydrophobized nanowires/nanowalls’ textured surfaces. The nanowires/nanowalls texturing of the surface enhances the pinning of the droplet on the impacted surface and lowers the droplet spreading. The maximum spreading diameter of the impacting droplet on the hydrophobized nanowires/nanowalls surfaces becomes smaller than that of the hydrophobized as-received silicon, hydrophobized graphite, micro-grooved, and nano-springs surfaces. Penetration of the impacted droplet fluid into the nanowall-cell structures increases trapped air pressure in the cells, acting as an air cushion at the interface of the droplet fluid and nanowalls’ top surface. This lowers the droplet pinning and reduces the work of droplet volume deformation while enhancing the droplet rebound height.     

Sudden bilateral vision loss in a COVID-19 patient: A case report

We present a Coronavirus disease 2019 (COVID-19) patient who developed sudden bilateral vision loss after a bilateral occipital ischemic stroke and without a history of stroke risk factors. An 84-year-old man was admitted to the emergency room with bilateral sudden vision loss while receiving Favipiravir treatment for 5 days following a COVID-19 diagnosis. The patient had no history of stroke risk factors, such as hypertension, diabetes mellitus, coronary artery disease, or arrhythmia. Diffusion magnetic resonance imaging of the patient revealed acute ischemia in the bilateral posterior occipital lobe and bilateral cerebellar hemisphere. We conclude that COVID-19 may rarely cause bilateral ischemic stroke presented only in the form of vision loss.     

Effects of Nigella unguicularis fixed oil on blood biochemistry and oxidant/antioxidant balance in rats

In the present study, Nigella unguicularis (Lam.) Spenner (Ranunculaceae) (Nu) fixed oil was administered orally to Wistar Kyoto rats for 4 weeks. The effects of the oil on serum lipid profile, haematological parameters and oxidant/antioxidant balance were investigated. The study showed that daily administration of the oil (1 ml/kg orally for 4 weeks) caused a significant decrease in serum total cholesterol, VLDL-cholesterol, triglycerides, glucose levels and a significant elevation of serum high-density lipoprotein level. The serum transaminases ( aspartate transaminase (AST), alanine transaminase (ALT)), alkaline phosphatase, bilirubin, blood urea nitrogen, urea, mean corpuscular haemoglobin concentration decreased significantly while albumin, mean corpuscular volume and fibrinogen levels increased significantly compared to control values. The administration of the oil (1 ml/kg orally for 4 weeks) caused a significant increase total antioxidant status in rats. Treatment with Nigella unguicularis oil did not effect malondialdehyde (MDA) concentrations. It is concluded that Nigella unguicularis oil possesses favourable metabolic effects on blood biochemistry and oxidant/antioxidant balance in rats.