Medical and Dental Consultantsí Association of Nigeria
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   2019| August  | Volume 22 | Issue 8  
    Online since August 14, 2019

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Daily versus twice daily dose of ferrous sulphate supplementation in pregnant women: A randomized clinical trial
JA Adaji, AY Isah, ET Agida, T Otu, HI Abdullahi
August 2019, 22(8):1132-1139
DOI:10.4103/njcp.njcp_211_18  PMID:31417058
Background: The International Nutritional Anaemia Consultative Group has recommended a twice daily dose of 65 mg elemental iron supplementation in pregnant women living in areas where anaemia is prevalent contrary to the World Health Organization (WHO) universal recommendation of a daily dose of 60 mg. Whether twice or daily dose schedules proffer a better outcome is a subject of on-going research. Objective: To compare the effectiveness of the once versus twice daily doses of ferrous sulphate in the prevention of iron deficiency anaemia in pregnancy. Methods: There are about one hundred and eighty two (182) pregnant women at gestational ages of 14-24 weeks with haemoglobin (Hb) levels ≥10 g/dl but ≤14.5 g/dl were recruited during the antenatal booking clinic. They were randomized into receiving either once daily dose (65 mg of elemental iron) or twice daily dose (130 mg of elemental iron) of ferrous sulphate. Pre and post- supplementation haemoglobin, serum iron and ferritin levels were assessed at recruitment and at 37 weeks gestation respectively. Results: Eighty-four (84) and 80 women respectively in the once and twice daily dose groups were analysed. The serum haemoglobin was significantly lower (P = 0.002) among those on once daily than those on twice daily supplementation. The side effects were however, significantly higher in the twice daily group (P = 0.005, P = 0.043 and P = 0.004 respectively). There were no differences between the serum ferritin levels pre and post supplementation in both groups just as they were no reported significant differences in both birth weight of neonates (P = 0.936) and average gestational age at delivery (P = 0.469) between the two groups. Conclusion: Once daily (65 mg elemental iron) ferrous sulphate is as effective as twice daily (130 mg elemental iron) dose regimen in prevention of Anaemia in pregnancy in a developing economy like Nigeria. Once daily dose possesses fewer side effects and guarantees better compliance in this study.
  5,618 339 -
Maxillary and mandibular all-on-four implant designs: A review
R Durkan, P Oyar, G Deste
August 2019, 22(8):1033-1040
DOI:10.4103/njcp.njcp_273_18  PMID:31417044
Objective: The objective of this review is to evaluate maxillary and mandibular all-on-four implant designs, their indications and contraindications, advantages and disadvantages. Methods: By using Pubmed, Cochrane Library, and Google Scholar, data from January 2003 to February 2018 were scanned electronically and manually as the title, abstract, and full text. The keywords specified were determined to be the all-on-four concept, full-arch implant prostheses, 4-implant full-arch, and tilted implants. The inclusion criteria consisted of the all-on-four implant design, its use in completely edentulous maxillary and mandibular cases, advantages and disadvantages of the technique, and changes observed in the maxilla and mandible in completely edentulous cases. Clinical trials and laboratory studies on the subject using the full text and English language were evaluated. Results: A total of 176 articles were found as a result of Google Scholar, Pubmed, and Cochrane Library. Thirty-seven articles were selected according to inclusion criteria; of these, 20 were related to the clinical trials. In addition, a total of 13 articles were found as a result of an additional hand search by screening the reference list of all included publications; of these, 11 was related to the clinical trials. Conclusions: It is necessary to carry out longer-term clinical and laboratory studies to determine long-term success criteria in all-on-four implant designs and to use new ceramic systems.
  1,645 523 -
A long-term clinical study on individuals with amelogenesis imperfecta
D Ceyhan, Z Kirzioglu, T Emek
August 2019, 22(8):1157-1162
DOI:10.4103/njcp.njcp_227_18  PMID:31417061
Background: The aims of this study are to present sociodemographic and familial characteristics, clinical and systemic findings, dental treatment needs, and concomitant dental anomalies in patients with amelogenesis imperfecta (AI) and to evaluate time-varying conditions in these long-term follow-up patients. Materials and Methods: Records of patients with AI who were examined in the Department of Pediatric Dentistry between 1999 and 2017 were reviewed. Information about sociodemographic characteristics, history of AI and consanguinity in family, systemic conditions, reasons for referral to the clinic, oral hygiene habits and gingival health, occlusion findings, and performed treatments were gathered. Dental anomalies in radiographs were also evaluated. Baseline and final situations of the patients were assessed. Statistical analyses were performed. Results: Of 75 patients aged 3–15 years with follow-ups up to 12 years, 34 had AI in their families and 15 were born from consanguineous marriages. Nephrocalcinosis has been observed in 5 patients. Main reasons for referral to the clinic were related to esthetic and hypersensitivity concerns. Twenty-two patients had gingivitis, and during follow-up process, gingival problems could not be completely prevented due to poor oral hygiene habits. Vertical dimension loss, open-bite, and cross-bite were seen in 16, 15, and 10 patients, respectively. Of the patients, 63% experienced restorative, 33% stainless steel crown, 17% endodontic, 8% prosthetic treatments, and 24% had retreatment needs. Concomitant dental anomalies were dens invaginatus, taurodontism, ectopic eruption, delayed eruption, hypodontia, and pulpal calcification. Conclusion: Early diagnosis and interventions considering the time-varying conditions with long-term follow-ups provide significant improvements in clinical maintenance of patients with AI.
  1,316 284 -
Demographic and clinical characteristics of keloids in an urban center in Sub-Sahara Africa
O Belie, AO Ugburo, BO Mofikoya
August 2019, 22(8):1049-1054
DOI:10.4103/njcp.njcp_395_18  PMID:31417046
Background: Keloid is a major complication of wound healing. The clinical spectrum ranges from unaesthetic lesions minimally invading the adjacent skin to large grotesque lesions sometimes associated with contractures. Subjects and Methods: The patients were seen over 2 years in a tertiary hospital setting. The following information was obtained with a proforma: the biodata, etiology of keloid, region affected, symptoms, and treatment prior to presentation. The keloids were examined and the sizes were grouped into small, medium, and large keloids; the severities of symptoms were determined using the visual analog scale. Results: 159 patients with 224 keloids were seen over 2-year period with male-to-female ratio of 1:1.24. The most common causes of keloid were trauma and acne (27.0% and 20.1%, respectively). The trunk had a statistically significant higher number of symptomatic keloid compared with other regions keloids. The larger keloids were more symptomatic compared with the smaller ones, P = 0.000. There were more pruritic keloids than painful ones. About 25% of patients had positive family history in first-degree relative, 16% in second-degree relative, and their keloid are more symptomatic than those without family history. Conclusion: In view of the burden of keloids, early treatment is advised. Unnecessary trauma and extra piercing should be avoided; elective surgeries that are deferrable should be postponed until when necessary.
  1,035 139 -
Salmonella Spp. and Shigella Spp. detection via multiplex real-time PCR and discrimination via MALDI-TOF MS in different animal raw milk samples
M Demirci, A Yigin, SK Altun, HK Uysal, S Saribas, BS Kocazeybek
August 2019, 22(8):1083-1090
DOI:10.4103/njcp.njcp_596_18  PMID:31417051
Aims: The aim of this study was to provide epidemiological data about the presence of Salmonella spp. and Shigella spp. in raw milk samples collected from different animals. Methods: A total of 231 raw milk samples from 48 cows, 65 goats, 65 sheep, and 53 donkeys were studied. The ISO 6579:2002 and ISO 21567:2004 methods, antimicrobial susceptibility tests, and serotyping were performed. Species and subspecies discriminations were made via matrix-assisted laser desorption/ionization-time of flight mass spectrometry. After DNA isolation from all samples, Salmonella spp. and Shigella spp. were detected using real-time polymerase chain reaction (PCR) kits. Results: Five samples (2.16%) showed positivity out of 231 raw milk samples for Salmonella spp., and 2 (0.87%) samples were detected to be positive by multiplex real-time PCR design. Conclusion: We found that raw milk samples were not free of Salmonella spp. and Shigella spp. and need to be tested routinely to avoid public health problems. Rapid and reliable real-time PCR method can be developed and used for this purposes instead of slow bacterial culture processes.
  976 181 -
Evaluation of cell and DNA damage induced by panoramic radiography
H Cakir Karabas, I Ozcan, L Turker Sener, S Dolek Guler, I Albeniz, TL Erdem
August 2019, 22(8):1041-1048
DOI:10.4103/njcp.njcp_675_18  PMID:31417045
Background: X-rays are potential mutagenic agents that can cause both the gene mutations and chromosomal aberrations. Aims: In this study, the micronucleus (MN) test and the comet assay methods are implemented in order to observe the damage that can occur in the cell nucleus and in the structure of DNA of the patients who underwent a panoramic examination. Methods and Materials: In our study, buccal mucosa swabs were obtained just before the radiography and 2 weeks after the radiography from 30 volunteer patients who had to take radiographs due to dental diagnosis. Changes in the nuclei of 1,000 cells of each swab sample had been counted under a light microscope and recorded. Besides, 100 cells of each other swab samples were analyzed by the comet assay. Comet assay parameters namely tail length and percentage of DNA in tail, which indicate the level of DNA damage were analyzed and compared in both groups. Statistical analysis was performed by using the Statistical Package for the Social Sciences (Version 21). Results: In our study, the results of percentage of DNA in tail and tail length before and after X-ray exposure were statistically significant (P < 0.001). Likewise, increase in the MN frequency observed in buccal mucosa cells after X-ray exposure was found significant (P < 0.001). Conclusions: As a result, panoramic radiographs taken during dental diagnosis and treatment cause cytotoxicity and DNA damage in oral mucosal cells. Panoramic radiographs should be applied only when necessary, using an accurate radiographic technique and radioprotection criteria.
  878 254 -
Hypertension and its risk factors among male adolescents in intermediate and secondary schools in Sakaka City, Aljouf Region of Saudi Arabia
A Bandy, MM Qarmush, AR Alrwilly, AA Albadi, AT Alshammari, MM Aldawasri
August 2019, 22(8):1140-1146
DOI:10.4103/njcp.njcp_507_18  PMID:31417059
Objective: Hypertension among adolescents is an emerging public health problem. The current study aims to estimate the burden of hypertension and identify its risk factors among male adolescents of intermediate and secondary schools. Subjects and Methods: This is a school-based cross-sectional study that targeted 400 male adolescents in the age group of 15–17 years. Blood pressure was defined as per the “Fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents”. An electronic device approved for use by the European Society of Hypertension International Protocol revision 2010, (Omron M3W; HEM-7202-E) was used for measuring blood pressure. CDC's body mass index tool was adopted for defining overweight and obesity. Descriptive analysis for hypertension and the risk factors were carried out. Chi-square test and odds ratios were calculated to assess any association between categorical variables. Results: Overall 36 (9.0%) adolescents had prehypertension and 69 (17.2%) had hypertension. Systolic prehypertension, systolic hypertension, diastolic prehypertension, and diastolic hypertension were present in 6.5%, 17.2%, 5.8%, and 9.0% of the adolescents, respectively. Bivariate analysis revealed that overweight and obesity, no physical activity, or once-a-week physical activity, positive family history of hypertension, and smoking were predictors of systolic prehypertension and showed a significant relationship with systolic hypertension. Conclusion: There is a considerable prevalence of prehypertension and hypertension, among school-going male adolescents. We recommend school-based health education programs and routine screening directed toward the risk factors of noncommunicable diseases like hypertension with special attention to obesity, physical inactivity, and smoking.
  954 133 -
Prevalence of obesity among adolescents in Eastern Turkey: A cross-sectional study with a review of the local literature
S Yilmaz, EO Calikoglu, Z Kosan
August 2019, 22(8):1070-1077
DOI:10.4103/njcp.njcp_418_18  PMID:31417049
Background: The World Health Organization defines obesity as an abnormal or excessive fat accumulation that can damage health. Aims: This study aims to evaluate the prevalence of obesity and risk factors in high school students in Erzurum City Center. Study Design and Methods: A cross-sectional study was conducted. The number of students participating in the study was 845, including 47.6% females and 52.4% males. Data collection was done by surveys filled in under supervision. Anthropometric measurements were performed by the researchers. Predictions of the Extended International Obesity Task Force were used for body mass index. Parents' body mass indexes were calculated by self-report and classified according to cut-off points for adults in the world health community. A systematic review of the local literature published between 2004 and 2013 was drafted. Results: In girls and boys, the frequency of overweight was 26.9% and 25.7%, respectively, while the frequency of obesity was 12.4% and 9.5%. A logistic regression analysis was performed to reveal significant risk factors for overweight/obesity. Weekly exercise status [odds ratio = 3.0, 95% confidence interval CI (1.2–7.8)] and school transfer % CI = (1.1–7.2) were important independent risk factors for obesity. The local literature showed a 4.3-fold increase in the prevalence of obesity within 10 years. Conclusion: The prevalence of obesity and overweight in adolescents requires the implementation of effective programs to fight this epidemic. Health education targeting peers and their parents, peer education, screening of risk groups, and controlling the sale of unhealthy foods can be some interventions.
  849 229 -
Accuracy of CBCT images in the volumetric assessment of residual root canal filling material: Effect of voxel size
F Yilmaz, G Sonmez, K Kamburoglu, C Koc, M Ocak, HH Celik
August 2019, 22(8):1091-1098
DOI:10.4103/njcp.njcp_678_18  PMID:31417052
Aims: Our aim was to compare three different voxel sizes of CBCT images for the determination of residual filling material volume in root canals when compared with micro CT. Material and Methods: Forty-two root canals of 14 extracted human maxillary molar teeth were retreated by using ProFile® instruments. Images were obtained after retreatment by using ProMax 3D Max CBCT at 3 different voxel sizes (1) High resolution (0.1 mm); (2) High definition (0.15 mm); and (3) Normal resolution (0.2 mm). Two observers measured volumes of residual filling materials in exported CBCT images by means of 3D Doctor Software. Micro CT measurements were served as gold standard. Mann-Whitney U test and Wilcoxon Test were used for the comparison of CBCT and micro CT measurements. Statistical significance was set at P < 0.05. Results: No statistically differences were found between the two observers for all measurements (P > 0.05). There were no significant differences among different CBCT voxel sizes used (0.1 mm, 0.15 mm, and 0.2 mm) (P > 0.05). The Spearman correlation coefficients between CBCT at different voxel sizes significantly highly correlated with micro CT measurements for each observer (P < 0.05). Furthermore, no significant differences were found between the measurements obtained by the two observers in consideration to root canal location (P > 0.05). Conclusion: CBCT images may provide useful information in the volumetric assessment of the amount of residual filling material in root canals for retreatment procedures.
  916 160 -
Which men have better attitudes and participation to family planning services? A study in primary care settings from Northern Turkey
G Yilmazel, F Cetinkaya, M Nacar, Z Baykan
August 2019, 22(8):1055-1062
DOI:10.4103/njcp.njcp_352_17  PMID:31417047
Background: Turkey is the third most populous country of the European region located at the crossroads of Asia, Europe, and the Middle East. In Turkey, approximately 2 million pregnancies occur every year. Half of the pregnancies are involuntary, and five out of every 100 pregnancies end with wanted abortion. There are limitations in access to modern methods in the north of Turkey. This study was aimed to determine the factors associated with better attitudes and participation to family planning (FP) services in primary care settings from Northern Turkey. Materials and Methods: This cross-sectional study, based on primary care settings, was conducted in the Middle Black Sea Region of Turkey with 400 married men. Male attitudes and participation were measured by a questionnaire form. Chi-square testing and logistic regression analyses were applied. Results: We found that male participation was present in 302 participants (75.5%), and 363 participants (90.8%) approved the use of FP. Male participation was significantly different by age, occupation, education, marriage age, spouses' education and occupation, and attitudes towards FP. Based on multivariate analysis, male participation was significantly associated with spouses' level of education, employment status, currently using FP, and the perception of spousal communication. Conclusion: Better participation existed among participants with higher educated spouses, employed spouses, current users of FP, and the better self-perception of communication.
  761 139 -
Osmotic demyelination syndrome following acute kidney injury with hypernatremia
NH Alkali, YB Jibrin, JA Dunga, A Abdu
August 2019, 22(8):1166-1168
DOI:10.4103/njcp.njcp_542_18  PMID:31417063
Osmotic demyelination syndrome (ODS) is a life-threatening neurological condition often associated with rapid correction of hyponatremia. While ODS is thought to be rare, with prevalence rates of not more than 0.5% in autopsy series, mortality rates are as high as 90% in some studies. Thus, timely diagnosis and life-saving treatment rest on a high index of suspicion among clinicians. In this report, we discuss the case and literature review of a 45-year-old female with sepsis, acute kidney injury, and spontaneous hypernatremia who developed ODS but responded to therapy with high dose steroids, antibiotics, and supportive care.
  781 110 -
Assessing agreement of hemoglobin and three- fold conversion of hematocrit as methods for detecting anemia in children living in malaria-endemic areas of Calabar, Nigeria
OA Oduwole, S Ameh, EB Esu, CM Oringanje, JT Meremikwu, MM Meremikwu
August 2019, 22(8):1078-1082
DOI:10.4103/njcp.njcp_66_19  PMID:31417050
Background: One of the major causes of anemia, defined as the reduction in the level of hemoglobin or red blood cells (RBCs) in the blood, in children in sub-Saharan Africa is malaria. Anemia is diagnosed by using either the hematocrit method or by measuring the hemoglobin concentration. Aims: To evaluate the relationship and agreement between hemoglobin and three-fold conversion of hematocrit results of participants in a clinical trial. Materials and Methods: This is a cross-sectional study that obtained data from a multi-center clinical trial that took place from 2007 to 2008 in public health facilities in Calabar, Nigeria. The hemoglobin and hematocrit results of 494 children who had ≥2000 parasite density recruited were pooled to evaluate the relationship and agreement between the two methods. The difference between the measures against the mean of the two measures was plotted according to the theory of Bland and Altman. Results: The mean age of the children was 34 months, with approximately equal number of boys and girls. The measured hemoglobin was lower than the calculated hemoglobin in 84.5% of the children. The result showed that lower the hemoglobin concentration, the higher the chances that the three-fold hematocrit conversion overestimates hemoglobin levels in the participants. Conclusions: The three-fold hematocrit conversion of hemoglobin estimation is a less reliable method than the measured hemoglobin in anemic children in the study setting.
  767 102 -
A case of transient diplopia and ophthalmoplegia following dental anesthesia
L Seres, G Petho, Z Peto, T Peto
August 2019, 22(8):1172-1174
DOI:10.4103/njcp.njcp_660_18  PMID:31417065
Dental anesthesia is one of the most frequently performed medical procedures. Although the frequency of ocular complications is extremely low, these reactions can be highly alarming and may bring up medicolegal issues when they do occur. Dentists and oral surgeons should be well-informed of these adverse reactions and should be aware that both ophthalmologists and emergency physicians might be required to care for these patients.
  727 111 -
The prognostic significance of the risk scores at upper gastrointestinal bleeding
Y Uysal, SB Babus, A Kose, F Ates, S Biricik, S Erdogan, I Cevik, I Toker, C Ayrik
August 2019, 22(8):1099-1108
DOI:10.4103/njcp.njcp_193_18  PMID:31417053
Background: Upper gastrointestinal system (GIS) bleeding is one of the most common causes of mortality and morbidity. The predictive values of pre-endoscopic Rockall score (PERS), full Rockall score (FRS), Glasgow-Blatchford score (GBS), pre-endoscopic Baylor score (PEBS), and full Baylor score (FBS) to predict bleeding at follow-up, endoscopic therapy, blood transfusion requirement, and death are investigated in our study. Methods: This study was retrospectively conducted in patients admitted to emergency department with upper GIS bleeding. Demographic and clinical characteristics of the patients were recorded. The relationships of the aforementioned scores with in-hospital termination, bleeding at follow-up, endoscopic therapy, blood transfusion requirement, and death were explored. Results: The study included a total of 420 subjects, of which 269 (64%) were men. All scoring systems were able to predict transfusion need and GBS was superior to other scores (P < 0.0001). In terms of endoscopic treatment, it was determined that only PERS, FRS, and FBS were statistically significant in predicting ability and PERS >3, FRS >5 and FBS >10 patients needed endoscopic treatment. All scoring systems were able to predict rebleeding. In comparison of two groups for rebleeding, it was found that PEBS was better able to predict bleeding during follow-up than both FRS and FBS, and PERS was better able to predict bleeding during follow-up than both FRS and FBS. All scoring systems were able to predict mortality. FRS and PERS scores had a greater discriminatory power for predicting death than the rest of the scores (P < 0.001). Conclusion: All scoring systems were effective for predicting need for blood transfusion, rebleeding, and death. GBS had more predictive power for transfusion need, PERS and PEBS for rebleeding, and FRS for mortality. PERS, FRS, and FBS were found to be effective in predicting endoscopic treatment.
  676 146 -
Radiographic assessment of the relationship between root canal treatment quality, coronal restoration quality, and periapical status
H Tercanli Alkis, A Kustarci
August 2019, 22(8):1126-1131
DOI:10.4103/njcp.njcp_129_19  PMID:31417057
Objective: The aim of this cross-sectional study was to assess the prevalence of apical periodontitis in root canal treated teeth in Turkish subpopulation and to evaluate the effects of both coronal restoration quality and root canal treatment (RCT) quality on apical periodontitis. Materials and Methods: Panoramic images of individuals who applied to our department for different diagnostic reasons were randomly and retrospectively scanned. Total RCT number, RCT quality, type of coronal restoration, restoration quality, periapical status, and total number of teeth were recorded. The criteria used for coronal restorations quality and RCT quality were defined by De Moor et al. and slightly modified by Gunduz et al. Periapical status was assessed by the periapical index developed by Orstavik et al. Pearson's Chi-square test was used for statistical analysis, and the intraobserver agreements were assessed by Kappa coefficients. Values of P < 0.05 were accepted to be meaningful. Results: The total examined teeth number was 6064, of which had 541 (8.9%) RCT. The prevelance of apical periodontitis was 40.5%. The number of adequate RCT was 178 (32.9%), and 138 (77.5%) of them were healthy. The number of adequate coronal restoration was 334, and 62.3% of them were healthy. For the cases that have adequate coronal restorations, there was statistically significant relationship between adequate RCT and periapical status (P < 0.001). Conclusion: The prevelance of apical periodontitis was 40.5% and there was statistically significant relationship between adequate RCT and periapical status.
  665 126 -
A short follow-up of prosthesis-based breast reconstruction using TiLOOP® Bra surgical mesh
WX Chen, L Cheng, LY Xu, YL Zhu
August 2019, 22(8):1115-1119
DOI:10.4103/njcp.njcp_487_18  PMID:31417055
Background: A new approach for prosthesis-based breast reconstruction is the use of a titanium-coated polypropylene mesh TiLOOP® Bra. However, the safety and outcomes are currently unclear in Chinese breast cancer patients. Methods: A retrospective study of patients undergoing prosthesis-based breast reconstruction using TiLOOP® Bra was carried out. Complications were divided into minor complications (require conservative treatment) and major complications (require surgical intervention). The influence of patient- and surgery-related characteristics on complications was analyzed. Results: Postoperative hematoma and seroma were respectively found in one and two breasts and could be treated conservatively. In three breasts skin infection occurred immediately after surgery resulting in skin necrosis of two breasts and wound dehiscence of one breast. These three breasts were treated with mesh removal, and revisionary surgery. Increased risk of mesh removal and implant explantation were observed in case of skin infection (P = 0.011) and skin necrosis (P = 0.033). Neither patient-related characteristics including age >50 years, BMI >25 kg/m2, and postoperative radiotherapy/chemotherapy, nor surgery-related characteristics including sentinel lymph node biopsy or axillary dissection alone, and curative/prophylactic surgery were significantly correlated with minor and major complications. Ultrasound evaluation showed a well-incorporated mesh into surrounding tissue. Conclusion: This titanium-coated polypropylene mesh showed acceptable complications and could be used safely in prosthesis-based breast reconstruction by stabilizing the implant pocket. Longer follow-up data and more randomized trials are necessary to determine the clinical use of this mesh.
  633 122 -
Burnout among family physicians in Turkey: A comparison of two different primary care systems
Z Kosan, A Aras, Y Cayir, EO Calikoglu
August 2019, 22(8):1063-1069
DOI:10.4103/njcp.njcp_355_17  PMID:31417048
Aim: The objective of this study was to determine the prevalence of burnout syndrome and associated factors among family physicians before and after family medicine system (FMS). Materials and Method: The first part of the study was conducted in 2008 (pre-FMS) and the second part in 2012 (post-FMS). Physician's burnout was investigated by using the Maslach Burnout Inventory (MBI). In total, 139 physicians had been participating pre-FMS and 246 physician's post-FMS. Results: The mean pre-FMS emotional exhaustion score was 15.7 ± 5.8, increasing significantly to 17.14 ± 7.5 post-FMS (P = 0.045). Mean pre-FMS and post-FMS depersonalization and reduced personal accomplishment scores were similar (P > 0.05). Age was negatively correlated with depersonalization in this study (P = 0.012) and positively correlated with personal accomplishment (P = 0.001). The primary care physicians in the post-FMS period were older, female physicians had a greater preference for primary care, and the levels of married doctors were higher. In addition, a higher level of physicians also owned their own home and cars compared to the pre-FMS period. A negative correlation has been reported between physicians' burnout levels and home or car ownership in the present study. Conclusion: Our findings suggest that physicians working under the family medicine system, a new primary care model, are at greater risk of emotional exhaustion, but that no change has occurred in terms of personal accomplishment or depersonalization, despite this new system.
  632 103 -
Association of sociodemographic factors and emotional intelligence with academic performance in clinical and preclinical dental courses
SB Haralur, MI Majeed, M Afzal, S Chaturvedi
August 2019, 22(8):1109-1114
DOI:10.4103/njcp.njcp_37_19  PMID:31417054
Background: The dental graduation program is stressful and challenging as it is essential to master various skills. The emotional intelligence (EI) is reported to help in perceiving, moderating emotions and also play a significant role in academic excellence. Aim: The aim of this study was to assess the sociodemographic factors influencing EI and to determine the association of EI in academic performance of clinical and preclinical courses. Materials and Methods: This cross-sectional study included the 113 dental clinical internship students from five different dental schools at Pakistan. The self-administered questionnaire data included sociodemographic factors, academic performance in preclinical, clinical courses, and San Diego City College MESA Program–based EI responses. The results were analyzed with multiple linear regression and ordinal regression to identify the independent predictor for EI and academic performance. Results: The female participants had marginally higher mean EI score (109.67) in comparison to male counterparts (108.10). The independent predictors among sociodemographic factors for EI were having siblings (P = 0.016), loss of parents (P = 0.002), parents' education (P = 0.022), and relation with parents (P = 0.03). The students enjoy studying dentistry were also associated with higher EI scores (P = 0.002). The mean EI score was an independent predictor of academic performance predominantly in clinical courses [β = −0.041 (95% confidence interval − 0.063 to − 0.020); P = 0.000]. Conclusion: The finding of the study indicates the influence of family and social factors in the development of EI. The dental students' EI is vital for higher academic performance in clinical courses.
  598 121 -
Influence of demographıc factors on perceıved socıal support among adult cancer patients in Turkey
T Ozbayir, F Gok, S Arican, BS Koze, Y Uslu
August 2019, 22(8):1147-1156
DOI:10.4103/njcp.njcp_372_17  PMID:31417060
Background: Social support, acknowledged as a protective factor against diseases, produces positive results in the prognosis of cancer patients. Objective: There is no relevant studies on perceived social support and factors related to Turkish cancer patients. Hence, the present study aimed to determine the demographic characteristics that affect the perceived social support in cancer patients undergoing chemotherapy in Turkey. Patients and Methods: This study was designed as a descriptive cross-sectional study. The sample included 423 adult cancer patients who admitted to the Outpatient Chemotherapy Unit of three hospitals in Turkey between March 2014 and August 2014. The data were collected through Demographic Characteristics Form and Cancer-Specific Social Support Scale (CPSSS). Results: Patients were between 19 and 85 years of age with a mean 51.75 years. Almost half of them (40.7%) were primary school graduates, 53.2% were female, 84.6% were married and 85.8% had children. It was found that the patients generally received a high score (127.86 ± 17.44) from the CPSSS scale. The highest scores were obtained on the Confidence Support sub dimension. It was revealed that women and married patients needed more confidence support and general social support (P < 0.05). Social support perceived by primary school graduates was statistically significant to a great extent (P < 0.05). In spite of the difference between the patients with metastasis and their perceived social support grade averages (P > 0.05), it was seen that patients with multiple children utilized more confidence support and general social support in social support reception (P < 0.05). Conclusion: The study showed that study participants received a high amount of social support. Age, gender, marital status, number of children, and educational status were determined to affect perceived social support. It is recommended to support the patients who do not receive sufficient social.
  597 97 -
Aortic stiffness in patients with wilson's disease
AS Gurbuz, S Ozturk, SC Efe, K Demir
August 2019, 22(8):1120-1125
DOI:10.4103/njcp.njcp_578_18  PMID:31417056
Aim: Wilson's disease (WD) presents with different phenotypes. Neurologic and liver involvement in WD are well documented. Few reports demonstrated cardiac and vascular involvement. Several studies showed an association between serum copper levels and atherosclerosis. Although WD is the prototype disease of copper metabolism, atherosclerosis has not been studied yet. The aim of this study is to assess aortic stiffness in WD. Materials and Methods: Aortic pulse wave velocity (PWV), augmentation pressure (AP), augmentation index (AIx), central aortic systolic, diastolic, mean, and pulse pressures were measured using SphygmoCor (AtCor Medical) device in 32 patients with WD and 24 healthy controls. Results: Patients with WD and healthy controls were similar in terms of age sex, body mass index (BMI), and liver and kiney functions. However, patients with WD were anemic and thrombocytopenic. Echocardiographic parameters including left ventricular, atrial dimensions, and systolic and diastolic functions were similar between two groups. Patients with WD and healthy controls were compared. Baseline characteristics including age, sex, and BMI did not differ between groups. Central aortic systolic, diastolic, mean, and pulse pressures were similar between the groups. AP, AIx, and PWV did not differ between groups as well. Conclusion: Aortic stiffness in WD was similar in healthy controls.
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Congenital segmental emphysema in an adult patient
A Gulsen
August 2019, 22(8):1163-1165
DOI:10.4103/njcp.njcp_141_18  PMID:31417062
Congenital segmental emphysema (CSE) is a disease characterized by severe hyperinflation of a specific segment of the lung without any intrinsic or extrinsic compression. It is most commonly observed in neonates and young children with acute respiratory distress. It is usually unilateral, and the left upper lobe of the lung is most often affected. Rarely, patients may remain asymptomatic until they are older and, therefore, may be diagnosed later. Cases unexplained until adulthood are sometimes detected incidentally as single-sided hyperinflation on a chest X-ray image. We have presented an extremely rare case where the patient remained asymptomatic until adulthood and did not exhibit any clinical findings.
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Coexistence of phylloides tumour and invasive ductal cancer in the breast
H Bozkurt, IB Karakaya, E Aktas, O Irkorucu
August 2019, 22(8):1169-1171
DOI:10.4103/njcp.njcp_602_18  PMID:31417064
Phylloides tumor in the breast is a rare fibroepithelial tumor, which is often seen in young adult women. Phylloides tumor of the breast accounts for about 1% of all breast tumors and approximately 3% of all fibroepithelial tumors. Pre-operative diagnosis is difficult. Since there aren't any specific mammography and ultrasound findings, they cannot be distinguished from fibroadenomas through these imaging methods and are mostly followed up as if they are fibroadenomas. Patients often present with the complaint of a mass that has been present for a long time and had started to grow suddenly. The primary preferred approach for treatment is wide local excision with negative surgical margins. Coexistence of invasive ductal carcinoma with phylloides tumor in the same breast is a very rare occurrence. We present in this article, a 42-year-old female patient with an invasive ductal carcinoma inside a phylloides tumor in the same breast.
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