Saddle nose deformity, palatal perforation and truncus arteriosus in a patient with Crohn’s disease

Crohn’s disease (CD) is a chronic granulomatous inflammatory bowel disease which may also involve the extraintestinal organs such as joints, liver, skin and perianal tissue. Involvement of the nasal cavity is quite rare in CD. This case report presents a 28-year-old girl with CD and saddle nose deformity, alar collapse and palatal perforation as extraintestinal manifestations of the disease in addition to persistent truncus arteriosus-type 4.     

Case report of a patient with osteopoikilosis

Osteopoikilosis (OPK) is an uncommon osteosclerotic dysplasia. There is no exact evidence of its etiology and pathogenesis. Usually, it is an asymptomatic disease, and the diagnosis is made incidentally from radiographs, which show multiple, small, well-defined, variably shaped and widely distributed sclerotic areas over the skeleton. In this study, we report a 54-year-old man who suffers from back and leg pain and was diagnosed OPK by radiologically and review literature.     

Segmental vitiligo in a patient with thoracic outlet syndrome

Reported here is a 35-year-old man with findings of thoracic outlet syndrome and bilateral segmental vitiligo on C8–T1 dermatomes. The possible causal relationship between the two disorders under the common denominator of cervical sympathetic involvement is discussed for the first time in the literature.     

DRESS syndrome with fatal results induced by sodium valproate in a patient with brucellosis and a positive cytoplasmic antineutrophilic cytoplasmic antibody test result

DRESS syndrome is a life-threatening adverse reaction characterized by skin rashes, fever, leukocytosis with eosinophilia or atypical lymphocytosis, lymph node enlargement, and liver or renal dysfunctions. DRESS syndrome related to valproic acid use is very rarely observed. We present a case of DRESS syndrome induced by sodium valproate, which developed and progressed fatally in a brucellosis patient with a positive c-ANCA test. A 19-year-old female patient presented with fever, cough, jaundice, and rash all over her body. Brucella Coombs test was positive at 1:1280 titers, and the Rose Bengal test was also positive. The involuntary movements were thought to be due to chorea, and the patient was started on sodium valproate 500 mg 2*1, as well as streptomycin 1?g flk 1*1 and tetradox capsules 2*1 for the brucellosis and was discharged. DRESS syndrome was suspected in the patient, and she was taken off sodium valproate and tetradox; N-acetylcysteine, ceftriaxon, prednizolone, and support treatment were started. When sodium valproate is used on its own, it carries no risk of inducing DRESS syndrome. However, in the case presented, another co-morbidity such as brucellosis and c-ANCA positivity was present. We believe that the presence of further co morbidity not yet reported in literature is important from the perspective of the risk of valproate-induced DRESS syndrome. Therefore, if sodium valproate treatment is to be started in patients, especially those with co morbidity, they must be closely monitored with clinical and laboratory observations. At the slightest suspicion of DRESS syndrome, all medication should be ceased immediately and the patient should be placed under continuous observation.     

Nanoleakage in primary teeth prepared by laser irradiation or bur

The aim of this in vitro study was to analyze hybrid layer and nanoleakage of composite resin restorations in cavities prepared by either Er,Cr:YSGG laser or bur, followed by acid etching in primary teeth. Ten extracted primary molar teeth were randomly allocated into two groups consisting of ten cavities according to surface treatment regimen: Er,Cr:YSGG laser + acid etching(group 1) and bur + acid etching(group 2). Restorations of all samples were completed. Then, teeth were sectioned and immersed to ammoniacal silver nitrate solution. After polishing, hybrid layer thicknesses were examined under scanning electron microscopy (SEM) and ion analysis was carried out with SEM/energy dispersive X-ray spectroscopy preparation in terms of nanoleakage. Hybrid layer thickness and the amount of silver ions were assessed for the acid-etched groups. The collected data were analyzed with independent sample t test and Spearman’s rank correlation. In groups 1 and 2, the mean hybrid layer thicknesses were 4.25?±?1.41 and 5.24?±?1.07 μm and the silver ion percentages were 10.97?±?13.81 and 22.79?±?21.62 %, respectively. Although no significant correlation was observed between the increase of hybrid layer thickness and the amount of silver ions, more silver ions were observed in group 2 (p?<?0.05). According to the results of this study, acid-etched cavities prepared with laser promoted better results when compared to the acid-etched cavities prepared with bur.