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   Table of Contents - Current issue
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April 2019
Volume 22 | Issue 4
Page Nos. 445-590

Online since Thursday, April 11, 2019

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REVIEW ARTICLE  

Do genetic polymorphisms affect susceptibility to periodontal disease? A literature review Highly accessed article p. 445
VE Toy, MO Uslu
DOI:10.4103/njcp.njcp_462_18  PMID:30975946
The pathogenesis of periodontal disease is not solely based on microbial dental plaque but is the result of the multifactorial and complex interaction between infection and host response. Many studies in the literature have demonstrated the differences between individuals in terms of host immune response and the presence of genetic components in numerous pathological conditions. Therefore, periodontitis may be defined as a complex genetic disorder with a phenotype formed by the genetic structure and environmental factors in the affected individual. So, determination of the genetic susceptibility profile associated with periodontitis might be very precious for developing novel diagnostic techniques and individual treatment strategies. To clarify the possible role of genetic polymorphisms in periodontal diseases, we searched PubMed for studies published on the subject since 1997 up to June 2018 and obtained data from original studies, meta analyzes, and systematic reviews. We included only case–control studies with large study populations.
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ORIGINAL ARTICLES Top

Correlation between intravesical prostatic protrusion and international prostate symptom score among Nigerian men with benign prostatic hyperplasia p. 454
BU Eze, TU Mbaeri, KC Oranusi, JA Abiahu, AM Nwofor, JC Orakwe, OO Mbonu
DOI:10.4103/njcp.njcp_324_18  PMID:30975947
Background: Intravesical prostatic protrusion (IPP) is a noninvasive test that can predict bladder outlet obstruction in patients with benign prostatic hyperplasia (BPH). Objective: The objective of this study was to determinethe correlation between IPP and International Prostate Symptom Score (IPSS) in patients with BPH. Patients and Methods: A cross-sectional prospective study of new patients with symptomatic BPH who presented to the urology clinics of NAUTH, Nnewi. Ethical approval and informed consent were obtained. Participants had abdominal ultrasonography measurements of IPP from midline sagittal image of the prostate (at bladder volume ≥100 mL) using Prosound SSD3500 with abdominal probe frequency of 3.5 MHz. IPP was divided into three grades (grade I: 0–4.9mm, grade II: 5.0–9.9 mm, and grade III: ≥10.0 mm). Data were analyzed using SPSS version 20. The data were subjected to analysis of variance, and Pearson's correlation was used to assess correlation where necessary. P value < 0.05 was considered significant. Results: In all, 101 men with a mean age of 67.09 ± 10.93 years were included in the study. The average IPSS, storage symptoms IPSS (IPSS-S), voiding symptoms IPSS (IPSS-V), Quality of Life (QoL) index, and IPP were 17.05 ± 7.62, 7.81 ± 5.17, 9.24 ± 3.16, 4.75 ± 1.59, and 13.50 ± 7.47 mm, respectively. There were significant differences between the mean IPSS (P = 0.000), mean IPSS-S (P = 0.000), and mean IPSS-V (P = 0.002) among the three grades of IPP. There were significant positive correlations between IPP and IPSS (P = 0.000), IPSS-S (P = 0.000), IPSS-V (P = 0.000), and IPSS QoL index (P = 0.000). Conclusion: There were significant positive correlations between IPP and IPSS, IPSS-S, IPSS-V, and IPSS QoL index.
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Relationship between self-efficacy and pain control in Iranian women with advanced knee osteoarthritis p. 460
N Mirmaroofi, A Ghahramanian, M Behshid, F Jabbarzadeh, TC Onyeka, M Asghari-Jafarabadi, J Ganjpour-Sales
DOI:10.4103/njcp.njcp_437_17  PMID:30975948
Objectives: This study aimed to determine the relationship between pain of osteoarthritis (OA) and body mass index (BMI), age, pain control strategy, self-efficacy for pain control, exercise, and functional activities in a cohort of Iranian women. Subjects and Methods: In total, 150 women with advanced knee OA, candidates for arthroplasty in Tabriz, in the Northwest of Iran were enrolled into the study. A convenience sampling method was used, and data was collected using demographic form, short-form McGill pain questionnaire, pain self-efficacy questionnaire, self-efficacy for exercise, and functional activities scales. Results: The present pain intensity of 74.7% of women was described as excruciating with mean (±SD) score 9.58 (±0.77) in the visual analogue scale. The majority of the women had a low self-efficacy for pain, exercise, and functional activities with means of 31.8, 17.28, and 57.63 respectively. There was a significant inverse relationship between sensory and affective components of pain and self-efficacy for pain control and functional activities (P < 0.001). The sensory and affective components of pain was related to age (P < 0.05), pain control self-efficacy (P < 0.01), and BMI (P < 0.05). A great majority of the women (79.33%) used complementary medicine (CM) for pain management. Those who used CM reported lower pain and higher self-efficacy (P < 0.01). Conclusion: The findings of this study suggest that life style modification and pain management education of women with OA and nurses on non-pharmacological interventions as well as integration of these into nursing care is essential.
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Investigation of the reliability of light-curing units in Sivas City, Turkey p. 469
D Eren, F Tutkan
DOI:10.4103/njcp.njcp_397_18  PMID:30975949
Background: The number of studies investigating the physical properties of light-curing units used in city centers in terms of the light intensity, presence of residues fractures at the tips, how long they have been used, and hardness measurements of the composite resins polymerized by these is limited. There is no such study in Turkey and Sivas province. The objective of this study is to examine the light-curing units used in Sivas city center and determine the reliability of light-curing units by measuring the surface hardness of composite samples polymerized with these devices. Materials and Methods: The power of the light-curing units that used in all private clinics in Sivas city center was measured. Then, the Vickers surface hardness measurements of the composite resin samples polymerized with these devices were made, and they were statistically evaluated. Results: The light intensity was found to be below from the acceptable value of 400 mW/cm2 in 10.7% of the devices. It was observed that with increasing years of usage, the light intensity of light-curing units decreased (P < 0.05). Conclusion: It was observed that as the power of light-curing units increased, the hardness values of the bottom and top surfaces increased significantly.
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Postoperative analgesia after total abdominal hysterectomy: Is the transversus abdominis plane block effective? p. 478
ZC Suner, D Kalayci, O Sen, M Kaya, S Unver, G Oguz
DOI:10.4103/njcp.njcp_61_15  PMID:30975950
Background: Analgesic protocol is needed following gynecologic surgery to ensure early mobilization, decrease the duration in the post-anesthetic care unit and hospitalization, and provide patient comfort. Transversus abdominis plane (TAP) blocks are used in the treatment of acute postoperative pain after lower abdominal surgery. TAP block may be a better choice of postoperative pain control. In the present study, the efficacy of ultrasound-guided TAP block on pain control and postoperative opioid consumption was evaluated in patients undergoing a total abdominal hysterectomy. Methods: Fifty patients undergoing total abdominal hysterectomy were included in this study. Patients were divided into TAP block (n = 25) and control groups (n = 25). Both groups postoperative patient-controlled analgesia (PCA) was planned during 24 h postoperatively. Patients were assessed 1, 2, 4, 6, 12, 18, and 24 h postoperatively using the Visual Analog Scale (VAS), Ramsey Sedation Score, PCA demand, morphine consumption, first analgesic requirement time, and adverse reactions. Results: When compared with the control group, the time to first analgesic requirement in the TAP block group was significantly lower (P < 0.05). The amount of additional analgesia also differed significantly (P < 0.001). In the TAP group, the VAS was significantly lower at 2, 4, 6, 12, 18, and 24 h postoperatively compared to the control group (P < 0.05). There was no statistically significant difference in adverse reactions. Conclusion: TAP block can effectively treat postoperative pain as part of multimodal analgesia in patients undergoing total abdominal hysterectomy.
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Locked intramedullary nailing using the sign nailing device p. 485
IC Nwagbara
DOI:10.4103/njcp.njcp_245_18  PMID:30975951
Objective: Locked intramedullary nailing is the treatment of choice not only in diaphyseal fractures of long bone but also in most metaphyseal and periarticular fractures. In this study, we set out to present our experience with the Surgical Implant Generation Network (SIGN)] technique of locked intramedullary nailing in long bones that do not require the use of image intensifier, fracture table, and power reamers. Patients and Methods: This was a hospital-based prospective descriptive study involving 54 consecutive patients seen over a 2-year period. All closed fractures of the femur and tibia/fibula seen within the period under review were included in the study. The patients were followed up for a minimum of 12 months. Fracture union was recorded when there was absence of pain at fracture site and X-ray shows presence of bridging callus in two orthogonal views. Results: Fifty seven fractures in 54 patients were managed in the period of the study. There were 46 [81%] femoral and 11 [19%] tibia/fibula fractures recorded in 47 [87%] males and 7 [13%] females with a male to female ratio of 6.7:1. Majority of the patients were within the 31--40 years age bracket (n = 25, 46%). All the fractures were as a result of motor vehicle accident. Thirty six (78%) of the femoral fractures were operated through the antegrade approach, whereas the rest (22%) were through the retrograde approach. Both proximal and distal locking were achieved in all cases. Fracture union was recorded in all but one case [98%]. Complications were observed in 8 cases, which included 5 cases of superficial infection, one case each of osteomyelitis, delayed union and nonunion. Conclusion: Locked intramedullary nailing using external jigs for screw placement as in the SIGN technique gives a good result and is recommended for use in the developing countries where image intensifiers are not readily available.
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Tibial fractures following participation in recreational football: Incidence and outcome p. 492
C Nwosu
DOI:10.4103/njcp.njcp_148_18  PMID:30975952
Background: Football is responsible for 3.5%–10% of all injuries treated in hospital, but this may reflect the popularity of the sport rather than its dangers. Young people are particularly at risk of sports injury because of high levels of exposure at a time of major physiological change. Soccer players are susceptible to a variety of injuries due to contact, aggressive tackle, and high-speed collisions. Aims: The aim of this study was to determine the pattern of presentation, treatment, and outcome of tibial fractures following participation in recreational football activity; with the hope that knowledge gained from this study will help in preventing or reducing its occurrence. Patients and Methods: This is a retrospective study of all cases of tibial fractures following participation in recreational football presenting to the Orthopedic Unit of Federal Medical Center and Surgery Department of Sir Yahaya Memorial Hospital all in Birnin Kebbi, Kebbi State, north western Nigeria; from January 2012 to December 2017. Data were extracted from the accident and emergency register, operation register, and patients' case folders on biodata, diagnosis, mechanism of injury, associated injuries, type of surgical procedure, site of surgery, date of surgery, and postoperative complications. Data collected were analyzed using the Statistical Package for Social Sciences for Windows version 22. Results were presented with descriptive statistics. Results: In total, 37 patients were included in the study. All of them were males. The age range is from 14 to 33 years with mean age of 23.6. 17 (45.9%) of the patients are in the 21- to 30-year age group. The right tibia was affected in 34 (91.9%) patients. None of the patients used shin guard. The mechanism of injury in all the cases was direct contact. About 31 (83.8%) of the fractures were closed. Seven (18.9%) of these patients were discharged against medical advice. Nineteen (51.3%) patients were managed nonoperatively with plaster of Paris casts. Ten (27.1%) of these patients had internal fixation with locked intramedullary nail. Conclusion: Tibial fractures following football occur mostly in males especially adolescents and youths. The right tibia was commonly affected and most of the injuries are closed. The most common mechanism of injury was direct contact.
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The effect of microwave glazing on the surface properties of various porcelain materials p. 496
FA Sanal, M Kurt
DOI:10.4103/njcp.njcp_116_17  PMID:30975953
Aim: The aim of this research was to investigate the effect of microwave glazing, conventional oven glazing, and polishing on surface roughness and wettability of porcelains. Materials and Methods: The initial surface roughness values (Ra0) of the prepared specimens for four different porcelains (Vita VM 9, VitaVM 13, Vita VMK 95, IPS e.maxCeram) were determined by profilometry. Then, the specimens were divided randomly into three groups as polishing, conventional oven glazing, and microwave glazing. Final surface roughness values were evaluated by profilometry (Ra1) and scanning electron microscopy. Wettability of glazed specimens were evaluated by contact angle goniometer. Results: Although microwave-glazed specimens had lower Ra1 values compared with the conventional oven-glazed ones for IPS e.maxCeram (P < 0.05), there were not any statistically significant differences between these two procedures in terms of Ra1 values for the other porcelains (P > 0.05). Microwave-glazed specimens had lower wettability values than conventional oven-glazed ones for Vita VM 9. Conclusions: Microwave glazing procedure may be considered as an alternative method because of the advantages of providing volumetric heating, time, and energy saving.
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The effect of pregabalin and ibuprofen combination for pain after third molar surgery p. 503
A Degirmenci, E Yalcin
DOI:10.4103/njcp.njcp_492_18  PMID:30975954
Aim: The objective of this study was to compare the efficacy of different doses of pregabalin and intravenous ibuprofen with regard to pain management and analgesic consumption after third molar surgery. Materials and Methods: Ninety patients who had been scheduled for third molar surgery were assigned to four different treatment groups. The inclusion criteria consisted of the presence of fully or partially bony retentive asymptomatic mandibular third molars. These groups are included the following: (Group 1) premedicated with oral placebo and intravenous (IV) placebo, (Group 2) premedicated with oral placebo and 400-mg IV Ibuprofen, (Group 3) premedicated with 75-mg oral pregabalin and 400-mg IV ibuprofen, and (Group 4) premedicated with 150-mg oral pregabalin and 400 mg IV ibuprofen. Postoperative pain was assessed with visual analog scale (VAS) every hour for the first 12 hs following the surgery. Pain was then assessed at different time intervals during 7 days following the surgery. Kruskal–Wallis tests were used to compare the four groups in terms of VAS pain scores, analgesic consumption, and first rescue analgesic request time after the surgery. Results: At the end of the study, the results of 80 patients (20 patients per group) were analyzed. The group 4 had lower pain intensity compared with other groups at various time intervals. This difference is statistically significant in between the first 3–10 h (first day) and single-time intervals in second, third, fifth, and sixth postoperative days. Postoperative analgesic consumption was not statistically different between the groups. The first rescue analgesic request time after surgery was different between the pregabalin combination groups and group 2. No significant difference in the side effects was observed. Conclusion: These findings suggest that preoperative coadministration of 150-mg pregabalin and IV ibuprofen may be useful in improving pain control after third molar surgery.
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Prognostic value of neutrophil-to-lymphocyte ratio in castration resistant prostate cancer: Single-centre study of Nigerian men p. 511
JO Bello, OO Olanipekun, AL Babata
DOI:10.4103/njcp.njcp_382_18  PMID:30975955
Background: Elevated neutrophil-to-lymphocyte ratio (NLR) has been suggested to be a useful prognosticator of overall survival (OS) in several cancers including castration resistant prostate cancer. However, its utility in black populations known to have benign ethnic neutropenia is unknown. We evaluated the prognostic value of NLR in Nigerian men with CRPC in terms of OS. Materials and Methods: We retrospectively analysed 58 patients with castration resistant prostate cancer who received androgen deprivation therapy (ADT) and docetaxel chemotherapy at our institution. Baseline NLR was calculated from available complete blood counts. NLR cut-off point value was determined based on receiver operator characteristic (ROC) curves for mortality. A multivariate analysis was performed to investigate the association between NLR and OS. Results: Based on the ROC curves, the NLR (AUC 0.85, 95% CI 0.74-0.97, P = 0.0001) cut-off point was determined to be 1.8. This cut-off point has a sensitivity of 92% and specificity of 70%. Median OS was 20 months (95% CI 14-27 months); the median OS in patients with NLR <1.8 and those with NLR of ≥1.8 was 40 months and 12 months respectively. Kaplan-Meier plots showed that a higher NLR of ≥1.8 correlated significantly with an increased risk of mortality, Log rank P = 0.001. Multivariate Cox regression analyses confirmed NLR as an independent prognostic biomarker for OS (HR = 1.49, 95% CI: 1.18-1.87). Conclusions: This study demonstrated that NLR is a useful prognostic biomarker in Nigerian men with CRPC and that elevated baseline NLR ≥1.8 is associated with poorer OS.
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Evaluation of quality of life, anxiety, and depression in the spouses of patients with obstructive sleep apnea syndrome p. 516
O Yazici, ON Hatipoglu
DOI:10.4103/njcp.njcp_500_18  PMID:30975956
Background: Impaired quality of life can be seen in the spouses of the obstructive sleep apnea syndrome (OSAS) patients. The main aim of the study is to assess the quality of life, anxiety, and depression in the spouses of the OSAS patients. Materials and Methods: A total of 100 OSAS patients and their spouses were included in the study. The demographic features of patients and the findings related to their disease and relevant clinical conditions were recorded. The quality of life of the spouses was evaluated by Short Form-36, their depression levels by Beck's depression inventory (BDI), anxiety levels by Beck's anxiety inventory, and the hospital anxiety and depression scale (HADS). Results: About 33% and 26% of patients' spouses showed depression by BDI and HADS, respectively; 14% of them showed anxiety by hospital anxiety scale. Among the subparameters of quality of life in spouses of patients who receive PAP (positive airway pressure) treatment, scores of physical condition, physical role restrictions, and role restrictions due to emotional problems were significantly higher than the ones in spouses of nontreated patients (P < 0.05). Depression scores of spouses of patients who use PAP were significantly lower than the ones who do not use the device (P < 0.05). A significant difference was not found between the two groups by means of anxiety scores (P > 0.05). Conclusion: The use of continuous PAP improves not only the quality of life for OSAS patients but also for their spouses and reduces the spouses' depression risk.
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Comparison of single-incision and conventional laparoscopic cholecystectomy in terms of quality of life, body image, and cosmesis p. 521
H Sinan, M Saydam, P Demir, MT Ozer, S Demirbas
DOI:10.4103/njcp.njcp_218_18  PMID:30975957
Background: Clinical studies indicate that single-incision laparoscopic cholecystectomy (SILC) has many advantages over conventional laparoscopic cholecystectomy (CLC), such as improved cosmesis, reduced postoperative pain, and shorter hospital stay. The aim of this study was to compare quality of life, body image, and cosmesis between single-incision laparoscopic and conventional laparoscopic approaches in patients undergoing cholecystectomies. Subjects and Methods: This retrospective study between SILC and CLC and was conducted among 58 patients undergoing SILC and CLC from January 2011 to March 2013 in Turkey. After the surgery, the EuroQol-5 Dimension Questionnaire (EQ-5D™), and body image questionnaire (BIQ) were administered to the patients. Results: Differences between the early and late postoperative scores in the EQ-5D were statistically significant (P < 0.001). Differences between most BIQ areas favored SILC, especially regarding cosmesis (P = 0.016); SILC patients had higher satisfaction with their scar's appearance. Conclusion: SILC is a promising alternative to traditional laparoscopic cholecystectomy in terms of quality of life, body image, and cosmesis in selected patients.
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A retrospective study: Do all impacted teeth cause pathology? p. 527
I Sarica, G Derindag, E Kurtuldu, ME Naralan, F Caglayan
DOI:10.4103/njcp.njcp_563_18  PMID:30975958
Objective: The objective of this study is to determine the incidence of impacted teeth and the frequency of pathologies they caused by cone beam computed tomography (CBCT) retrospectively. Materials and Methods: In this study, 608 patients' CBCT images were analyzed retrospectively. Detected impacted teeth were classified as incisor, canine, premolar, molar, third molar, and supernumerary teeth. The pathologies caused by impacted teeth are classified as cysts or tumors, tooth decay, root resorptions, and periodontal bone loss. Results: Impacted teeth were detected in 34.37% of the 608 CBCT images included in the study. The distribution of impacted teeth was 9.4% incisor, 29.4% canine, 9.9% premolar, 2.9% molar, 9.3% supernumerary, and 39.9% third molar teeth. Approximately 63.7% of the impacted teeth caused a pathology. The pathology that was most commonly caused by impacted teeth was periodontal bone loss (44.4%), and respectively others were root resorptions (33.3%), cysts or tumors (8.6%), and tooth decay (2.3%). The most common cause of this pathology was right mandibular third molar teeth. Conclusion: Impacted teeth were common and they often caused a pathology. CBCT is a useful device to assess the impacted teeth. When the impacted teeth are evaluated, each tooth should be assessed within itself. If the impacted teeth are not caused by pathology, they can be kept under control.
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Serological and virological markers of nigerian patients with hepatitis B infection p. 534
OA Lesi, RA Audu, AP Okwuraiwe, OO Adeleye, FA Ige, JC Iwuorah
DOI:10.4103/njcp.njcp_273_17  PMID:30975959
Background: The natural history of chronic hepatitis B virus (HBV) infection and the spectrum of diseases attributable to chronic hepatitis B are diverse. It is estimated that 15%–25% of chronic carriers will die from complications of progressive disease such as liver cirrhosis, hepatocellular carcinoma, and hepatic decompensation. The main aim of this study is to evaluate the serological and virological profile of patients with hepatitis B infection to enhance the evaluation of the natural history of viral hepatitis in an endemic population. Methods: Characteristics of hepatitis B surface antigen (HBsAg) patients (2010–2016) were extracted from the database of a reference laboratory in Lagos. These included serological tests for hepatitis B antigens (HBeAg, HBsAg), antibodies (anti-HBcIgM, anti-HBeAb) (DIA.PRO), and HBV DNA (Roche Diagnostics). SPSS version 20.0 was used for data analysis. Results: Of the 1,983 patients, 1,252 were male and 731 female. HBeAg was detected in 8.0% (128/1,605) of the subjects, anti-HBe was positive in 90.0% (1,257/1,396), while HBcore subclass IgM antibody was detected in 12.6% (116/930). Detectable HBV DNA was identified in 1,781 (89%), with viral load exceeding 2,001 IU/mL in 712 (35.9%) subjects. HBV viral loads >200,000 IU/mL were more frequently detected in HBeAg-positive compared with HBeAg-negative subjects (65.7% vs 4.9%, P < 0.0001). Conclusion: We have demonstrated the predominance of low replicative phase HBV infection and highlighted the importance of HBeAg-negative infections that may require antiviral therapy. HBeAg-positive infections occurred significantly in younger adults with new or acute infections. Our findings have implications for patient evaluation and planning of hepatitis treatment programs.
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Evaluation of intraocular pressure and retinal nerve fiber layer, retinal ganglion cell, central macular thickness, and choroidal thickness using optical coherence tomography in obese children and healthy controls p. 539
RT Baran, SO Baran, NF Toraman, S Filiz, H Demirbilek
DOI:10.4103/njcp.njcp_471_18  PMID:30975960
Objective: Obesity affects many organ systems. There have been few studies on the ophthalmological effects of obesity. The aim of the present study was to evaluate the changes in the ophthalmological parameters in obese children. Subjects and Methods: The study included 61 obese and 35 age-and gender-matched control subjects. Obesity was defined as body mass index-standard deviation score (BMI-SDS) >2 SD. Children with a BMI-SDS between >−1 SD and <+1 SD whilst otherwise healthy were recruited as the control group. All clinical and ophthalmological investigations were performed by a pediatric endocrinologist and an experienced ophthalmologist. The ophthalmological examination and intraocular pressure (IOP) measurement was performed. The average retinal fiber layer (RNFL), retinal ganglion cell (RGC), central macular thickness (CMT), cup-to-disk ratio (C/D), and central choroidal thickness (CT) were measured using spectral domain optical coherence tomography. The anthropometric, biochemical, and ophthalmological parameters of the obese and control subjects were compared. Results: IOP was higher in the obese group compared to the control group (P = 0.008), whereas the average RNFL was lower in the obese group (P = 0.035). There was a negative correlation between the average RNFL and BMI-SDS (P = −0.044) and waist–hip ratio (P = 0.015). There was no statistically significant difference between the RGC, C/D, CMT, and CT of the obese and control groups. IOP was negatively correlated with HOMA-IR, body fat mass, body fat percentage, and diastolic blood pressure. Conclusion: In the present study, which evaluated obesity and its effects on ophthalmological parameters, the elevated IOP and decreased RNFL thickness detected in the obese group may suggest an increased risk for these patients of developing glaucoma at a younger age. Therefore, regular ophthalmological examinations of obese children are essential for prompt diagnosis and appropriate management.
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Comparison of the effect of advanced platelet-rich fibrin and leukocyte- and platelet-rich fibrin on outcomes after removal of impacted mandibular third molar: A randomized split-mouth study p. 546
MG Caymaz, LO Uyanik
DOI:10.4103/njcp.njcp_473_18  PMID:30975961
Aim: In this study, it was aimed to investigate and compare the postoperative effects of leukocyte- and platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) in terms of pain, swelling, and trismus after mandibular third molar surgery. Subjects and Methods: The study included a total of 27 patients with bilateral impacted mandibular third molar, which surgically operated at different times. Patients were evaluated in two randomly separated groups. For the first and second group, A-PRF and L-PRF were applied into the tooth socket, respectively. The outcome variables were pain, swelling, the number of analgesics taken, and trismus. These variables were also assessed based on first, second, third, and seventh days following the operation. Statistical Analysis Used: The data were collected and analyzed with unpaired Student's t-test and Mann–Whitney U test. Results: The study was conducted with 27 patients, consisting of 15 females and 12 males between ages of 18–26. The visual analog scale pain scores of the L-PRF group during first (P < 0.05), second, and third days and total values (P < 0.01); the number of analgesics on days 2 (P < 0.01) and 3; and their total values (P < 0.05) were significantly higher than the A-PRF group. There was no significant difference between swelling, trismus, and the duration of operation (P > 0.05). Conclusion: The results of this study showed that the use of A-PRF after mandibular third molar extraction significantly reduces postoperative pain and the patients need to take analgesics of A-PRF group compared to L-PRF group.
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Comparison of mesiodistal tooth width in individuals from three ethnic groups in Southern Saudi Arabia p. 553
RA Togoo, WA Alqahtani, EK Abdullah, AS A Alqahtani, I AlShahrani, M Zakirulla, KA Alhotellah, OH Mujam
DOI:10.4103/njcp.njcp_593_18  PMID:30975962
Objective: The aim of this study was to compare the mesiodistal tooth sizes and to see the gender dimorphism among three ethnic groups of southern part of Saudi Arabia, that is, Asir, Najran, and Jizan region. Subjects and Methods: The sample composed of 90 individuals (45 of each gender) from 3 different regions of southern Saudi Arabia, having mean age of 26.9 years. The measurements were done directly on the models with the aid of the digital calliper measuring the largest mesiodistal measure of incisors, canines, premolars, and molars in both sides. Results: Almost all the mesiodistal tooth widths were statistically significant between the groups except maxillary and mandibular permanent third molars. Regarding sexual dimorphism, the groups were combined; almost all the mesiodistal tooth widths were not shown statistically significant difference between the males and females except that right first permanent premolars were significantly larger in the females than in the males. Conclusion: The present study has provided norms of the mesiodistal permanent tooth diameters of a Saudi population that are newer and more complete than the previously published norms. There appear to be some secular trends in the mesiodistal diameter of the Saudi permanent teeth toward sexual dimorphism.
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Prevalence and determinants of depression among patients with hypertension: A cross-sectional comparison study in Ghana and Nigeria p. 558
AD Ademola, V Boima, AO Odusola, F Agyekum, CE Nwafor, BL Salako
DOI:10.4103/njcp.njcp_351_18  PMID:30975963
Background: Despite evidence linking depression to poor blood pressure (BP) control and increased hypertension-related morbidity and mortality, there is paucity of data about depression among patients with hypertension in sub-Saharan Africa. We assessed factors associated with depression among patients with hypertension in Ghana and Nigeria. Subjects and Methods: Patients with hypertension were recruited from four hospitals: In Ghana, Korle Bu Teaching Hospital (n = 120), and in Nigeria, the University of Port Harcourt Teaching Hospital, the Lagos State General Hospital, and the University College Hospital Ibadan (n = 237). Demographic, socioeconomic, psychosocial, and clinical factors which predicted depression among the study cohort were assessed by logistic regression. Depression and beliefs about medications were assessed with the Patient Health Questionnaire (PHQ-9) and the Beliefs about Medication Questionnaire, respectively. Depression was regarded as PHQ-9 score >4. Results: The mean ages of the Ghanaian and Nigerian cohort were 57.0 ± 13.7 years (58.3% female) and 56.4 ± 12.9 years (57.0% female), respectively. Prevalence of depression was 41.7% and 26.6% among the Ghanaian and Nigerian cohorts, respectively. Significant predictors of depression in the Nigerian cohort were age in years [OR 0.97 (0.95–0.99)], concern about medications [OR 1.15 (1.03–1.30)], and poor BP control [OR 2.06 (1.09–3.88)]. Young age was the only independent predictor of depression in the Nigerian cohort. In the Ghanaian cohort, none of the factors significantly predicted depression. Conclusion: Prevalence of depression is high among patients with hypertension in Ghana and Nigeria. Screening and treatment of depression among patients with hypertension in Ghana and Nigeria may have important implications for improving outcomes.
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Shear bond strength and microleakage of novel glass-ionomer cements: An In vitro Study p. 566
E Meral, NM Baseren
DOI:10.4103/njcp.njcp_543_18  PMID:30975964
Background: The overall success of dental restorations depends on the materials' ability to bond to dental structures and to eliminate the microleakage. Therefore, the aim of this study was to evaluate the shear bond strength (SBS) and microleakage of novel glass-ionomer restorative materials. Materials and Methods: In this study 62 intact molars were used, of which 30 molars were sectioned buccolingually, embedded in acrylic resin, and polished to obtain flat dentin surfaces. Then, glass-ionomer cylinders were built on the specimens (n = 15) with a high-viscosity glass-ionomer cement (GIC) (EQUIA Fil), a glass-carbomer (Glassfill), a zirconia-reinforced GIC (Zirconomer), or a conventional GIC (RivaSelfCure), and SBS testing was performed. For microleakage test, Class V cavities were prepared on buccal and lingual surfaces of the remaining 32 teeth and divided into four groups (n = 16). Each group was restored with one of four GICs and subjected to microleakage testing. The data were statistically analyzed (P = 0.05). Results: The highest SBS values were observed in Glassfill group (P < 0.05). There were no significant differences on the SBS values of other three materials (P > 0.05). Regarding microleakage evaluations, no significant differences were observed at enamel margins (P > 0.05), whereas at dentin margins, EQUIA Fil and Zirconomer showed less microleakage than Glassfill (P < 0.05). Conclusions: Although the glass-carbomer restorative materials revealed higher SBS, other tested materials might be more reliable in clinical use, as they offer better leakage resistance.
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Investigation of Vitamin D levels in medical staff in a dental clinic p. 573
F Dogruel, ZB Gonen, DG Canpolat, H Ocak, F Bayram
DOI:10.4103/njcp.njcp_523_18  PMID:30975965
Aims: Recently, Vitamin D deficiency is pandemic now. The main reason of vitamin D deficiency is inadequate exposure to sunlight. Vitamin D level in nutrients is low and it can be ineffective to meet the daily requirements. Vitamin D is synthesized in the skin by ultraviolent radiation. In the present study, the authors aimed to investigate serum 25(OH) D levels of the medical staff working in different positions in the Faculty of Dentistry. Subjects and Methods: A total of 51 dentists, 28 dental assistants, 11 secretaries, and 10 nurses working in the Faculty of Dentistry, Erciyes University between November and December 2014 were included to the study. The serum 25(OH) D levels of the participants were evaluated. Results: Of the participants, 62 were females and 38 were males with a mean age of 30.17 ± 5.77 (range: 20–49) years. The mean vitamin D levels were found to be 12.1 ± 8.37 ng/mL (range: 2.1–38.3). A total of 51 participants had severe vitamin D insufficiency, while three participants had normal vitamin D levels with only one dentist. Conclusion: According to the results of present study, dental staff should be considered as a high-risk group for vitamin D deficiency. Vitamin D deficiency and insufficiency is a common problem among medical staffs as in several working groups such as white-collar workers and bankers. Results of present study suggest that insufficient exposure to the sunlight may lead to severe vitamin D deficiency in dental professionals. Vitamin D supplementation may be recommended to the dental staff.
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CASE REPORTS Top

Ruptured cystic teratoma associated with mucinous cystadenoma in a pregnant woman p. 578
O Aydin, F Pehlivanli, G Karaca, G Aydin, CD Sayan, P Atasoy, CE Daphan
DOI:10.4103/njcp.njcp_144_18  PMID:30975966
Mature cystic teratoma is the most common ovarian neoplasm. However, mucinous cystadenoma with teratoma has been very rarely reported in literature. This case report, which is very rare, describes a clinical entity not previously reported in literature. A 34-year-old pregnant woman presented in the 23rd gestational week with severe right lower quadrant pain. She was diagnosed with acute abdomen and was then treated surgically. During the surgical intervention, a spontaneously ruptured mass was detected in the right ovary. This was reported histopathologically as a mature cystic teratoma in collision with mucinous cystadenoma. To the best of our knowledge, this case report is the first to have identified a ruptured mature cystic teratoma in collision with mucinous cystadenoma in a pregnant woman.
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Invasive fungal consecutive infections in a patient with acute myeloid leukaemia p. 582
SR Safai Nodeh, SA Dehghan Manshadi, B Jahanbin, S Khodaveisi, F Giasvand, A Seifi, M Salehi
DOI:10.4103/njcp.njcp_359_17  PMID:30975967
A woman with AML who became febrile and neutropenic after chemotherapy. At the first, Aspergillus was isolated from a sinus biopsy. After 4 weeks, while she was taking voriconazole, another episode of fever combined with dry coughs was detected. Fungal culture and histopathology of sinus biopsy revealed mucormycosis.
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Metastatic lung cancer associated with Warthin's tumour p. 585
MA Haberal, E Akar, OS Dikis
DOI:10.4103/njcp.njcp_424_18  PMID:30975968
Warthin's tumors which can easily be subjected to misinterpretation are encountered commonly in clinical practice. Warthin's tumors which generally have the localization of parotid gland cauda and have a slow growing characteristic can rarely be seen aside from parotid gland; such as cervical lymph nodes and minor salivary glands. A 56-year-old patient's case that comprised atypical coexistence of Warthin tumor with PET/CT scan positive cervical lymph nodes during the diagnostic examination carried out for a pulmonary mass lesion is presented. While the transthoracic biopsy performed for the mass indicated non-small cell lung carcinoma, histopathologic diagnosis established for the lymph node reported Warthin tumor. Early detection of Warthin tumor may result in earlier diagnosis of lung cancer since patients with Warthin tumor have a higher risk of lung malignancy.
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Aggressive squamous cell carcinoma of the renal pelvis p. 588
I Kartal, S Uysal, A Adabag, A Gok, AL Sagnak, H Ersoy
DOI:10.4103/njcp.njcp_434_18  PMID:30975969
Squamous cell carcinoma (SCC) of the renal pelvis is a particularly rare tumor that accounts for a minor portion of renal malignancies and is aggressive with an unfavorable prognosis. It is usually diagnosed after surgery and at advanced stages as it does not possess specific clinical and radiological properties. The pathological examination of a 38-year-old female patient who had undergone nephrectomy due to a nonfunctioning right kidney caused by long-standing staghorn calculus revealed moderately differentiated renal pelvis SCC invading the renal parenchyma. The patient who experienced severe lumbar pain in the second postoperative month presented lymphadenopathy, which could not be detected with ultrasonography but was diagnosed with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET/CT). The patient received systemic treatment following the early diagnosis and survived past the average survival time. It was concluded that in cases where SCC was diagnosed after nephrectomy, investigating metastasis with 18FDG PET/CT and initiating early systemic treatment in the presence of metastasis could contribute to survival.
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