The genital system remains one of the most common sites of carcinogenesis in women. Advances in surgery, radiation treatment, and chemotherapy have increased their efficacy and many patients survive for many years after their initial diagnosis. The eye is a rare site of metastasis from gynecological cancer due to its distant location from the genitalia. In this systematic review, we retrieved all case reports of patients with ocular metastasis from gynecological neoplasms. The demographic, clinical, and treatment characteristics were retrieved and analyzed. A total of 70 case reports were included. Forty-eight of these reports concerned patients with a known malignancy that recurred in the eye and in 22 patients' ocular symptomatology accompanied the initial diagnosis of the gynecologic malignancy. 73.9% of these patients exhibited concomitant metastasis to other organs. The mean disease-free interval was found at 25.7 months and mean survival time after the eye metastasis was 13.5 months. Refractory disease was identified as the most important risk factor associated with mortality. Because eye metastasis has such a dismal prognosis, all gynecologists who treat oncological patients should be highly suspicious for reported eye complaints.

Schistosomiasis is a neglected infectious tropical disease that is second in occurrence only to hookworm infection in sub-Saharan Africa. Presently, chemotherapy is the main method of control and treatment of this disease due to the absence of a vaccine. However, Praziquantel, which is the only chemotherapeutic option, lacks efficacy against the early developmental stages of schistosomes. A number of plant-derived compounds, including alkaloids, terpenes and phenolics, have displayed in vitro and in vivo efficacy against Schistosoma species. This review explores how the application of nanotechnology can improve the efficacy of these plant-derived schistosomicidal compounds through the use of nano-enabled drug delivery systems to improve bioavailability.

The systematic review aimed to report the prevalence of electronic cigarette (e-cigarette) usage among medical students in Saudi Arabia. Electronic databases were searched for scientific research articles published from January 2010 until December 2020. The data search was performed in electronic search engines such as PubMed, Google Scholar, Scopus, Web of Science, Medline, Embase, Cochrane, and Saudi Digital Library. A total of five research articles that qualified the eligibility criteria were analyzed for qualitative data. The sample size in the included studies ranged from 229 to 1007 participants. The prevalence of e-cigarette usage ranged from 10.6% to 27.7% among medical students in Saudi Arabia. Studies have also reported that the prevalence of e-cigarette usage is higher among the male population in comparison with the female population. The prevalence of e-cigarette usage among medical students in Saudi Arabia is high. Similar to tobacco smoking, e-cigarette usage is a major public health issue and concern among the younger population because they have potential benefits in some and are harmful to some and also it is still unclear whether they are effective for quitting smoking. Regulatory bodies must focus and initiate strict laws and policies to minimize the sales of these products to the younger population. Health promotion strategies need to be developed to reduce the usage of e-cigarettes.

Background: Shoulder dystocia is an emergency and risky situation that most likely directly involves midwives. Aim: The aim of this study is to determine the effects of simulation training with a high fidelity mannequin on midwives' shoulder dystocia management. Subjects and Methods: This study utilized a quantitative, quasi-experimental research design. No sample selection was made. The study included all midwives (n:16) working in the maternity unit of Manisa Province Hospital, Turkey. Management of shoulder dystocia was lectured both theoretically and practically, using a high fidelity simulation. Midwives' shoulder dystocia management skills and knowledge were evaluated before and after training using shoulder dystocia knowledge form and management skill checklist. Results: There was a statistically significant increase in their shoulder dystocia management knowledge scores and management skills after simulation-based shoulder dystocia training (P < 0.05). Before the training, the midwives (62.5%) mostly used the McRoberts maneuver and suprapubic pressure as the primary interventions in shoulder dystocia management. After training, all the midwives were able to apply secondary maneuvers (Wood's or Rubin's maneuvres or posterior arm delivery) along with the primary maneuvers, in accordance with the shoulder dystocia management algorithm. Conclusion: Using a high fidelity simulation model in training increased midwives' shoulder dystocia management skills and knowledge.

Background: There is a global rise in shisha smoking amongst the youths. Information on the prevalence and knowledge of the constituents and the harmful effects of shisha smoking is important for the development of prevention strategies and policies. Aim: This cross-sectional study aimed to assess the knowledge and sociodemographic predictors of shisha smoking among the university students. Subjects and Methods: A structured 12-item questionnaire was administered to the university students at the University of Port Harcourt, Rivers State. The prevalence, knowledge, and predictors of shisha smoking and the association between sociodemographic factors were studied. A P value of <0.05 was considered statistically significant. Results: Among the 546 university students studied, 24.7% (135) had smoked shisha. The percentage of those knowledgeable about the constituents and its ill effects of shisha smoking was 14.8% (81), those with poor knowledge was 94.1% among shisha smokers. Females and social sciences students demonstrated statistically significant better knowledge of shisha (P = 0.007, and 0.027, respectively). The main predictors of shisha smoking were: poor knowledge (odd ratio, OR = 4.48, 95% confidence interval, CI [2.02, 9.93], P = 0.001), being in 400 level of study (OR = 2.63, 95% CI [1.12, 6.13], P = 0.724) and being in the faculty of social science (OR = 1.25, 95% CI [0.50, 3.09], P = 0.638). Conclusions: The prevalence of shisha smoking in this study was 24.7%, and the most influential factors were the level of study, type of faculty, and knowledge of the constituents and harmful effects of shisha. Lecturers and administrators of different faculties of the university should be engaged to include shisha smoking prevention programs in their curriculum.

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Background: Urethroplasty is the gold standard treatment procedure for male patients with urethral stricture and is becoming increasingly popular among urologists worldwide. Procedure success rates have risen with increased experience. Aims: Here we aimed to examine the results of urethroplasty in challenging cases of urethral stricture and its effect on sexual function. Patients and Methods: Data were collected retrospectively from the patients who had undergone urethroplasty after multiple failed direct vision internal urethrotomy (DVIUs) from 2017 to 2020. All patients were monitored for a minimum of 12 months. Outcomes of urethroplasty were analyzed according to stricture location, length, and the number of prior DVIUs. Penile length and sensation, erectile, and ejaculatory function of the patients were evaluated pre- and postoperatively. Results: The patient cohort consisted of 36 males with a mean age of 63 ± 3.2 years. The most prevalent stricture etiology was iatrogenic (83%). Patients who underwent three or more DVIUs before urethroplasty and stricture length >4 cm were included in the analysis. Accordingly, the overall success rate was 83% (30/36). When the success rate and the IIEF5 scores were assessed separately, there was no significant relationship between the number of DVIUs (P > 0.05). Similarly, no significant relationship was also found with the stricture length (P > 0.05). Conclusion: Appropriate and correctly applied surgical technique does not impair sexual activity, even in patients with severe urethral stricture, regardless of the length or location of the stricture and the number of prior endoscopic procedures.

Background: Obesity is an important public health issue with an increasing prevalence in Turkey as well as throughout the world. Aims: The purpose of this study is to identify the prevalence of obesity in women of reproductive age group living in Adıyaman which is located in southeastern Turkey and the factors related to it. Patients and Methods: This descriptive study was carried out with 1,100 women registered at Family Health Centers in the Adıyaman city center. Data were collected through a face-to-face survey method and evaluated on a computer. Chi-square and logistic regression evaluations were used in comparisons and P < 0.05 was considered statistically significant. Results: The mean age of the women was 32.94 ± 8.65; 78.3% of them were homemakers, and half were elementary school graduates or less educated; 57.6% of the women were overweight with 24.1% being obese. It was observed that women's body mass index increased with their age and decreased with higher levels of education. Also, the study showed that the risk of being overweight increased 3,2 times for married women and 2,0 times for unemployed women. Additionally, the rate of women being overweight was higher among the women with more number of previous pregnancies. Conclusion: Prevalence of obesity among women of reproductive age was high in the Adıyaman city center. Specific training should be planned, especially for women with low education levels, for fighting obesity.

Background: Polycystic ovary syndrome (PCOS) is common in women of reproductive age. Aim: This study aimed to investigate the impact of individual counseling program which had been designed from the transtheoretical model (TM) for students diagnosed with PCOS. Patients and Methods: The study is a prospective randomized controlled trial. The research was carried out in four stages as screening, diagnosis, randomization, selection, and counseling. The data for the analysis were drawn from a sample of 854 students at first and a total of 67 students were administered the scales. The control (n = 33) and experimental groups (n = 34) were formed based on the simple randomization technique. The sample characteristics were voluntary participation, absence of sexual activity for a minimum of 6 months, belonging to the age group of 19–24, an absence of chronic diseases or any physical disability, and a lack of mental disorders. Participants using medication and obtaining scores of above/below 18.5 and below/above 30 on the body mass index (BMI) were not included in the study. Results: The prevalence of PCOS among university students was found to be 8.8%. The findings indicated that the majority of the students have been experiencing various physical symptoms such as being overweight, menstrual irregularity, hirsutism, alopecia, acne, and psychological symptoms such as uneasiness, irritability, anger, anxiety, and fatigue. Based on the pretest and posttest scores, it was observed that the anthropometric values and psychological indicators such as the feeling of uneasiness, irritability, anger, anxiety, and fatigue were significantly decreased in the group of PCOS that took the counseling program. Conclusions: Individual counseling improved the anthropometric measurements and the clinical findings related to PCOS.

Background: The publication rate of abstracts is a measure of the quality of scientific meetings. Aims: The present study aimed to determine the radiation oncologists' publication rates of abstracts presented at the National Radiation Oncology Congresses (UROK) and National Cancer Congresses (UKK) and identify the top journals that published these studies. Materials and Methods: We reviewed the abstracts presented at UROK and UKK, held between 2013 and 2017. To retrieve any publications originating from the presented abstracts, we searched the match terms in the public databases, including PubMed, Web of Science, Google Scholar, The Turkish Academic Network, and Information Center (ULAKBIM). We evaluated the articles' publication dates and peer-review history and noted the journals' impact factors. Results: Three thousand seven hundred six abstracts were accepted for presentation; 1178 papers met the study criteria and were included in the analyses. There were 297 oral and 881 poster presentations. The overall publication rate was 18.9%. The median time to publication was 12 months. The studies were published in 94 scientific journals with a median impact factor of 1.28. Breast cancer and lung cancer studies had the highest publication rates among all subspecialties (15.2%). Retrospective studies had higher publication rates than those with other study designs (P < 0.0001). Conclusion: Almost 20% of abstracts presented at UROK and UKK were converted into full-text publications. Most of the abstracts achieved publication within 2 years from the presentation. Oral presentations had a significantly higher publication rate than poster presentations, reflecting their higher quality. The authors' affiliations and the study designs were among the significant factors that determine publication success.

Background: Assessment of intravascular volume status is important in pediatric patients admitted to the emergency departments and pediatric intensive care units. Inferior vena cava (IVC) diameter and collapsibility index are used to evaluate the intravascular volume status in adults. The normal range of IVC diameter is available for adults and the normal range considered for adults is between 1.7 to 2.1 cm, but such normative data is limited for children of all ages. Aims: Our aim in this study was to obtain the IVC and the aorta diameter reference values and the mean vena cava collapsibility index in healthy and normovolemic children. Subjects and Methods: Vena cava inferior and aorta images in B mode were obtained. IVC diameter in the inspiratory and the largest IVC diameter in the expiratory were recorded, and the vena cava collapsibility index was calculated. Results: Ultrasonographic measurements were performed in total on 1938 children. A significant positive correlation was found between IVC and aorta diameters with age. The collapsibility index was found as 37.2% (SD 11.8) in the overall study population. In addition, the reference values for the IVC and aorta diameters obtained from the measurements were also acquired. Conclusions: We believe that our IVC and aorta diameter measurements obtained from a large number of participants may be used as reference values in emergency departments and intensive care units.

Background and Aim: This study assessed the demographic, treatment, and patient characteristics relating to 2-year postoperative failure and success rate of 2 to 12-years-old healthy children that underwent various dental procedures during comprehensive dental treatment under general anesthesia (GA). Materials and Methods: A retrospective study was conducted after the completion of a 2-year postoperative follow-up examination. The hospital records of all the children were reviewed by an experienced examiner. In the follow-up appointment, the clinical and radiographic evaluations of the treatments, oral hygiene, and oral hygiene practices were recorded. A P value of <0.05 was set as statistically significant. Results: Around 221 healthy children were included in the study, with a mean (SD) age of 4.92 (1.37). The most common type of failure detected 2 years postoperatively were recurrent decay (mean = 2.68, SD = 2.50), followed by stainless steel crown (SSC) open margin (mean = 0.69, SD = 1.02). Children with good oral hygiene involved the highest number of successful procedures (mean = 5.28, SD = 1.99) (P = 0.032). Children with poor oral hygiene was the factor that involved the highest number of procedure failures (mean = 8.28, SD = 3.38) (P < 0.001). The Pearson correlation coefficient showed that the younger the mean age of children during treatment under GA, the higher the rate of dental procedure failure (r = −0.202, n = 221, P < 0.01). Conclusion: The failure rate of dental procedures performed during treatment under GA was highest among younger children and children with poor oral hygiene at the time of treatment. SSC crown restoration was the most common type of dental procedure received, and recurrent decay and SSC open margin were the most common types of failure detected.

Background and Aim: The purpose of this in vivo study was to investigate the effect of translucent adhesive resin cement on the final color of ceramic laminate veneer restoration before and after polymerization in intraoral conditions. Materials and Methods: This study was conducted in 92 ceramic laminate veneer restorations of 27 patients. The ceramic laminate veneer restorations in standard thickness lithium disilicate ceramic structure (IPS e.max Press HT, Ivoclar Vivadent) were cemented to the tooth with translucent light-polymerized resin cement (Choice 2 Starter Kit, Bisco). Results: It was observed a clinically noticeable color change between ΔE values before and after polymerization (ΔE >3.3). There was a statistically significant difference in b* values, ΔL value, and Δb value. Conclusion: Within the limitations of this in vivo study, the results suggest that light polymerization of the translucent resin cement (Choice 2, Bisco) used is an important factor for the final color of the restoration and should be considered during shade selection and fabrication.

Background and Aim: The aim of our study is to prepare a head–neck phantom model for ultrasound suitable for submandibular anatomy to be used in the education of research assistants in the department of radiology in dentistry, and to compare different materials for this purpose. Materials and Methods: To make the planned phantom model, we used aluminum foil suitable for the curvature of the mandible instead of bone, pasta, or parsley stalk and balloon/glove to mimic the myofascial structure instead of muscles, tube of an infusion system instead of blood vessels, ketchup/mayonnaise/honey instead of gland structures (in a small balloon), and small balloons filled with water or mayonnaise with a tube of an infusion system or pipette instead of lymph nodes. Results: After the examinations, it was decided to put ballistic gel for soft tissue, aluminum foil for bone, spaghetti and ketchup in a balloon for muscle, mayonnaise in small balloons for lymph nodes, ketchup in a balloon for submandibular gland, and a tube of an infusion system for the artery. Conclusion: The submandibular region phantom can be a useful tool for learning the sonoanatomy of the head, neck, and submandibular region and improving the ability to use ultrasound. The advantage of the prepared model is that it is easy to use, prepare and apply materials accessible to any dentist, and can be used over and over again.

Background: Systemic immune-inflammation index (SII) is increasingly valued for its simplicity and predictability. Anesthesia/analgesia technique may affect cancer survey. Aims: The primary aim of this study is to offer a comparative evaluation for the effect of different anesthesia/analgesia techniques employed in radical prostatectomy surgery on SII, a new inflammatory index. Patients and Methods: Eighty-one patients who underwent radical prostatectomy between January 1, 2012, and December 31, 2020, were included in the study. We recorded oncological demographic data of Group G (n = 45) and Group GE (n = 36), preoperative and postoperative (within the first 4 hrs and 24^th hr) SII values, perioperative surgical bleeding, and amount of blood transfusion. Results: Despite the lack of significant difference in the SII values between the groups, both the peak SII level and the SII change in the postoperative period became higher in Group G than in Group GE. In addition, the amount of surgical bleeding and blood transfusion was observed to be significantly lower in Group GE (P < 0.001, P = 0.092, respectively). Conclusions: GE in radical prostatectomy surgery in terms of SII, the SII change in the postoperative period was more pronounced in Group G. However, a significant difference was noted in surgical bleeding in Group GE. We can conclude that comparing the SII values of different anesthesia techniques with prospective studies might thus create a difference in survival and metastasis at the micro-level.

Background: Evidence-based information should be provided to clinicians to explain the effectiveness of hydrophilic and hydrophobic forms of resin based sealants (RBSs). Aim: To assess and evaluate the retention and cariostatic effect of hydrophilic and hydrophobic RBSs in primary and/ or permanent teeth with at least a follow-up period of 3 months. Materials and Methods: Five databases were searched up to September 2021 for randomized and non-randomized clinical trials (RCTs and non-RCTs) that evaluated the retention and cariostatic effect of hydrophilic and hydrophobic RBSs. Two authors nominated the papers, extracted data, and assessed the risk of bias. Results: By comparing the retention rate and caries incidence between groups, pooled-effect estimates of included articles were generated. After removing duplicates from the 2,810 titles found, only 1938 remained. Twelve of these were thoroughly examined. A total of 12 papers met the inclusion criteria in qualitative analysis: seven RCTs and five non-RCTs. Only ten studies were included in the meta-analysis: five RCTs and five non-RCTs. After 12 months of follow-up, no significant difference was found in the retention of hydrophilic and hydrophobic RBSs with and without a bonding agent. After 12 months of follow-up, no significant difference was found in the cariostatic effect of hydrophilic and hydrophobic RBSs. Conclusion: There was no statistically significant difference in retention and the cariostatic impact was found between hydrophilic and hydrophobic RBSs.

Background: Neonatal mortality remains unacceptably high in most sub-Saharan and Asian communities, where cultural practices and poor antenatal care are common. Newborn care practices play a key role in preventing neonatal deaths. Aims: This study aimed to examine similarities and variations in newborn care between two major ethnic groups in northeast Nigeria. Subjects And Methods: Qualitative methods involving narratives, observations, focus group discussions, and in-depth interviews were used to collect data from recent mothers (ten per ethnic group) and grandmothers from the Babur/Bura and Kanuri ethnic groups in Borno State, Northeast Nigeria. A snowballing sampling technique was used to select the participants within four communities/villages (two for each ethnic group). Results: Babies were bathed within 30 to 45 minutes after delivery by mothers in both groups, except in case of ill health of the child and/or mother. Various substances were applied to the cord even though hygienic cord-cutting practice was reported. With the exception of early bathing, good thermal care practices were observed in both groups. Both groups applied emollients on the skin of the babies, but Bura preferred the use of shea butter to oils and lotion. Various substances were applied to other parts of the body of the baby, such as the fontanelle (Mahogany oil), anus (Neem oil and Mahogany oil), and circumcision wound (engine oil) more so among the Bura than the Kanuri. None of the substances were deemed to be harmful. Conclusion: Similarities and variations in newborn care exist between the two ethnic groups. There is a need for health education and promotion to encourage and facilitate positive behavioral change from old traditional practices to healthy newborn care practices among the Babur/Bura and Kanuri ethnic groups.

Background: The whole root canal disinfection is crucial in terms of long-term endodontic success. In this context, applying medicaments following effective irrigation activation procedures becomes an important point. Aims: The purpose of this study was to evaluate and compare the efficacy of various irrigation activation techniques on non-infected dentinal tubule penetration of calcium hydroxide (CH), double (DAP), and triple (TAP) antibiotic pastes. Materials and Methods: A total of 180 extracted human permanent mandibular premolar single-rooted teeth were selected and randomly divided into a control group and four main groups according to the irrigation activation procedures (n = 36) as KTP laser irradiation, conventional needle, NaviTip FX, sonic (SI) and ultrasonic activation (UI) procedures. Each group was randomly subdivided into three subgroups according to the medicament type (n = 12); CH, DAP, and TAP. After the activation procedures, the root canals were filled with CH, TAP, and DAP mixed with 0.1% fluorescent rhodamine B isothiocyanate. Specimens were sectioned at 2, 5, and 8 mm from the apex, and all the sections were examined under a confocal laser scanning microscope to calculate the dentinal tubule penetration. Data were analyzed using a three-way analysis of variance and Tukey's post hoc tests (P = 0.05). Results: TAP provided a statistically significant greater penetration than the other groups (P < 0.05). UI provided a statistically significant higher dentinal tubules penetration area than other activation procedures (P < 0.05). Conclusion: Medicament penetration depends on the type of medicament, activation procedures, and root canal level. The TAP may be preferred following the ultrasonic activation in terms of long term root canal treatment success.

Background: Proguanil is currently the recommended drug used for malaria chemoprophylaxis in children with Sickle cell anaemia (SCA). Aims: This study aims to determine the uptake and usage of proguanil as malaria chemoprophylaxis and the socioeconomic determinants of its usage in children aged 6–59 months. This was a descriptive cross-sectional study carried out in two major sickle cell clinics in Benin City, Edo state, Nigeria. A total of 420 participants were interviewed using semistructured questionnaires. Patients and Methods: Descriptive, bivariate, and multivariate analysis of quantitative data were done using SPSS version 21. Results: The uptake of proguanil among study participants was 67.4%; of these number, 268 (94.7%) reported daily use of proguanil. Only 3 (0.7%) used pyrimethamine as chemoprophylaxis, while 134 (31.9%) used no form of malaria chemoprophylaxis. Having mothers with higher level of education (LOE) (P = 0.013, odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.15–3.17), attending clinic at the University of Benin Teaching Hospital (UBTH) (P = 0.044, OR = 2.15, 95% CI = 1.02–4.54), older age group (36–59 months) (P = 0.015, OR = 1.67, 95% CI = 1.11–2.51), and owning insecticide-treated net (ITN) (P = 0.000, OR = 3.11, 95% CI = 1.98–4.88) were significant positive predictors for the usage of proguanil. Conclusion: Proguanil uptake was low. Attending sickle-cell clinic at UBTH, having mothers with tertiary LOE, and owning ITN were social factors associated with high usage of proguanil amongst children with SCA. Continuous monitoring and evaluation of the uptake and usage of proguanil in children is important, so as to aid policy implementation and review.

Background: Breast reduction is a common and safe procedure with predicted cosmetic outcomes. Many techniques have evolved over the recent decades. Aims: The aim of this study is to determine what type of breast reduction techniques are currently preferred among board certificated Saudi plastic surgeons and assess the surgeons' satisfaction, surgeon-reported patient satisfaction, and complication rates post breast reduction with the preferred techniques. Materials and Methods: This is a cross-sectional questionnaire-based study. The questionnaire was adapted from previously published studies and distributed to a small group before full-scale distribution to Saudi plastic surgeons by email and communication groups. Results: The mean age of the participants was 45.4 (± 8.9). Most participants were males (82%), and the majority held a Saudi board (44%), and 20% held a Canadian board. Significant differences between different board certifications, held fellowship, and years of experience emerged in terms of surgical preferences. The two most common complications reported by surgeons were suture splitting (34%) and excess scarring (24%). Conclusions: In Saudi Arabia, inverted T resection patterns with superior or superomedial pedicle designs are the standard techniques used in breast reduction, with higher satisfaction rates and fewer complications. Surgical preferences were significantly different between surgeons based on their training and held fellowships.

Background: Although distance education has been received as an effective educational method in dentistry, the assessment of distance learning and online-exam methods in instantaneous conditions such as a pandemic has not been completely researched. Aims: The purpose of the present study was to assess student satisfaction with the distance learning and online-exam experience of dental students in Turkey during the pandemic. Subjects and Methods: Dental students in selected Turkish universities were invited to participate in the research. As a data collection tool, socio-demographic data and a web-based questionnaire consisting of 23 questions, addressing the problems experienced in education during the Covid-19 pandemic period and questioning the solutions of students regarding these problems were used. Satisfaction and attitudes towards distance education and online exams were examined. Results: A total of 1375 students participated in the study. The percentages of students at the various grades of dental school were as follows: first grade = 11.2%, second grade = 18.2%, third grade = 28.3%, fourth grade = 27%, and fifth grade = 15.1%. There is a significant relationship between classes and all scale expressions (P < 0.05). While 11.2% of the students who responded had not experienced any problems, the most common problem was that practical training could not be performed (45.8%) and the lessons were inefficient (29.7%). Conclusions: Dental students demonstrated a low degree of satisfaction and a negative attitude towards distance learning and the quality of presentation of educational material.

Background: Colorectal cancer (CRC) is one of the most common malignancies seen in the Western World. It is increasing in developing countries due to adaptation of the western lifestyle with an incidence of 6% in Nigeria. Treatment options are dependent on the stage of disease at presentation, the performance status of the patient, and increasingly the molecular makeup of the tumor. There is a dearth of data on the treatment options obtainable for the management and outcome of CRC cases in Northwestern, Nigeria. Aim: The study assessed the treatment options and outcome of colorectal cancer patients in a tertiary institution, in Northwestern, Nigeria over a 10-year period. Patients and Methods: Between January 2006 and December 2015, data of one-hundred and twenty-two histologically confirmed colorectal cancer cases seen at the Surgery, Radiotherapy and Oncology Departments, ABUTH Zaria, were retrieved retrospectively from the case files and treatment cards of the patients at the health information unit of the hospital. The stage at disease presentation, treatment received, and outcome were analyzed. Results: Nearly a quarter of the patients fell within the age bracket 31–40 years with the median age being 41 years. While only 41% of the patients had their disease staged, 30.4% of the patients presented with advanced disease (Dukes'C + D). Only 95 cases received a form of surgery or the other. Colostomy however accounted for 28.4%. Eighty-nine of the patients received chemotherapy either as neoadjuvant, adjuvant or with palliative intent. External beam radiotherapy either with radical or palliative intent was received by 60 patients (49.2%). At 1-year follow-up sixty cases had been lost to follow up, and thirty-six cases had defaulted on one form of treatment. Conclusion: The study showed that stage at presentation and the available treatment options in the hospital informed treatment offered to the patients. However, surgery was readily performed due to the pattern of presentation and most patients benefited from just a diverting colostomy. Majority of the patients presented with rectal tumor which required radiotherapy as part of its treatment modality, although this is still a luxury in this part of the world. Chemotherapy is also readily available and often prescribed. Cost and limited facility for biomarker (K-ras) testing restrict the use of targeted therapy. Outcome at 1-year follow-up was poor with whereabouts of nearly half of the patients unknown.

Background: Periodontal disease diagnosis and its stability after treatment are still a field of interest for both researchers and clinicians. Aims: First aim of this study was to implement the new periodontal classification for the reflection of periodontitis severity in private practice. Second, periodontal stability and tooth loss were observed in patients who attended supportive periodontal therapy (SPT). Patients and Methods: A total of 454 patients were classified according to the new classification. To define periodontitis, patients were staged according to the clinical attachment level, and tooth and bone loss. Grading was also assessed by bone loss to age ratio, smoking, and/or presence of diabetes. Associations between periodontitis and age, gender, presence of diabetes, and smoking were also analyzed. Additionally, periodontal stability, tooth loss, and adherence to oral hygiene were recorded for those who attended SPT. Results: One hundred five patients were diagnosed as generalized gingivitis and 349 patients as periodontitis. Among them, 166 suffered from severe periodontitis (stage 3 or 4). Most of the patients had stage 3 grade C periodontitis (40.4%). Out of the 344 patients who attended SPT at least once, no treatment was needed in 57 (16.6%) patients who were accepted periodontally stable. Twenty-nine patients lost at least one tooth due to periodontal reason. Conclusions: According to the new periodontal classification, 47.6% of the patients had severe periodontitis (stage 3 or 4). Periodontal stability was observed in 16.6% of patients who attended SPT.

Background: The amniotic fluid index (AFI) is one of the parameters used to assess fetal well-being and predict perinatal outcomes. There is, however, a dearth of studies on the pregnancy outcomes of women with borderline AFI in Nigerian and African women. Aim: To compare the pregnancy outcomes of Nigerian women with borderline and normal amniotic fluid index. Subjects and Methods: This was a prospective cohort study conducted at two health facilities in Delta State, Southern Nigeria. A total of 114 pregnant women attending the antenatal clinics with singleton pregnancies at gestational age 37 to 41 + 6 weeks were recruited over a 5-month period. Fifty-seven subjects with borderline amniotic fluid index were matched with an equal number of subjects with the normal amniotic fluid index for gestational age, age of the parturient, and parity. These women were followed up till delivery, and pregnancy outcomes were determined. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 22 software. Results: The results showed that borderline amniotic fluid index was associated with increased risk of adverse pregnancy outcomes including intrapartum fetal distress, Appearance, Pulse, Grimace, Activity, and Respiration (Apgar) score <7 in 5 min, and birthweight <2.5 kg, and these were statistically significant (P = 0.04, 0.01, and 0.04, respectively). Conclusions: Borderline AFI is associated with an increased risk of adverse pregnancy outcomes in low-risk Nigerian women.

Background: Although its etiology is not fully known, the accepted view is that bruxism is a multifactorial disorder. Aims: This study aims to evaluate the prevalance of self-reported bruxism and to investigate its relationship with psychological and sociodemographical factors amongst undergraduate dental students in Zonguldak, Turkey. Subjects and Methods: 250 dental students were asked to fill the bruxism questionnaire – to detect the prevelance of bruxism; personal information form – to determine sociodemographic variables; and symptom checklist-90-R (SCL-90-R) – to asses psychological state. Data were analyzed statistically by Kolmogorov Smirnov, Shapiro Wilk, Mann Whitney U, and Kruskal Wallis tests through Statistical Package for the Social Sciences (SPSS) program. Results: The prevalance of self-reported bruxism was 40%. 46% of the students showed higher levels of psychological symptoms. SCL-90-R subscales showed statistically significant differences in students with bruxism compared to those without bruxism (P < 0.05). It was observed that bruxism was associated with gender (P < 0.05) and both bruxism and psychological symptom levels were statistically higher in females (P < 0.05). Conclusions: The findings revealed that, although bruxism was common among dental students, gender and psychosocial factors are also mostly associated with the etiology of bruxism. In this context, during the challenging dentistry education period, it is important to direct students who are found to have high levels of psychological symptoms to psychological counseling and guidance services.

Background: Routine medical screening usually involves periodic history taking, physical examination, and laboratory tests on a regular basis for asymptomatic individuals for continuing self-health care. Aim: This study aimed to determine the knowledge, practice, and factors affecting practice of routine medical screening among health workers in Delta State University Teaching Hospital, Oghara. Subjects and Methods: The study population comprised all staff of the hospital. The sample size was determined using the Yamane formula; n = N/1 + N (e) = 295. A structured questionnaire was distributed among the various staff of the hospital that consented to participate in the study by agreeing to complete the questionnaire. Permission for the study was obtained from Ethics committee of the hospital. Data analysis was by SPSS version 22 (IBM). Results: About 297 participants completed their questionnaires. Female respondents (53.20%) participated more than males (46.80%). Nurses made up 25.5%, 18.8% were doctors, and 16.4% were administrative staff. Among the respondents, knowledge score was good in 58.3%, fair in 25.1%, and poor in 25.1%. The perception score among the respondents was good in 187 and poor in 110. The main reasons for not doing routine medical screening in the last one year were attributed to cost of tests (36.4%). The main reasons for doing a medical test in the past one year were mainly because of illness (60.0%). The practice of routine medical screening score was good in (26.2%) and poor in (73.7%). There was statistically significant association between sex and practice of routine medical screening, females had better practice of routine medical screening compared to men, P = 0.004. The main factors that affected routine medical screening were sex, being managed for a medical condition, and cost of the medical screening. Conclusion: The practice of routine medical screening by the health care workers in our region is poor despite the demonstration of a good knowledge. The major factors affecting uptake of routine medical screening were sex, history of being managed for a health condition, and financial constraint. Staff of the hospital should be better enlightened on the use and importance of the Contributory Health Scheme in routine medical screening.

Giant congenital melanocytic nevus (GCMN) is a rare congenital benign neoplasm with the potential to become malignant. Various extracutaneous malformations may accompany GCMN. Acetabular dysplasia accompanying GCMN was described in previous studies. To the best of our knowledge, this case report of ours is the first reported case of GCMN diagnosed and treated with hip dislocation based on developmental dysplasia of the hip (DDH). The rare coexistence prompted us to report this case.

Sessile serrated adenomas (SSA) of the appendix and anaplastic carcinoma mural nodules arising in the mucinous ovarian tumors (MOT) are rare lesions. We report a case of SSA in the appendix coexisting with an anaplastic carcinoma mural nodule in MOT. No BRAC1/BRAC2 germline mutations were found in the peripheral blood sample. The paraffin-embedded tissue from normal tissue (as a control), MOT, mural nodule, and SSA of the appendix were separately sequenced by next-generation sequencing (NGS). Based on the NGS results, stop-gain, chromosome DEL or TRA in mural nodules and SSA were detected, which were different from those in the mucinous tumors. In conclusion, we reported a case of SSA in the appendix coexisting with a mural nodule in MOT. We describe the morphological characteristics and molecular detection results in this case. There was no clear genetic evidence of a correlation between these two rare pathological types.

Diffuse alveolar hemorrhage (DAH) disease is a rare but acutely developing condition that may occur after general anesthesia, if not diagnosed and treated on time, could be life-threatening. Orthognathic surgeries, frequently performed for functional and esthetic correction, are generally composed of a young population in their twenties with no other disease. The aim of presenting this case report was to describe the etiology, diagnosis, and treatment of DAH to emphasize the importance of timely diagnosis.

Insulinoma is the most common functional solitary, benign pancreatic neuroendocrine tumor. In this paper, we share our experience of triple pancreatic insulinomas, with an idea to highlight the fact that despite the high frequency of solitary insulinoma, there is the possibility of multiple lesions and point out the need for a systematic and detailed radiographic and clinical examination. A 33-year-old woman was admitted to our clinic due to chronic fatigue, sweating, sporadic episodes of palpitations, unsteady hands, and blurred images, which resolve spontaneously after a few minutes. A comprehensive radiological examination revealed two lesions in the pancreatic tail, highly indicative of neuroendocrine tumor – insulinoma, so we elected for surgical treatment. Intraoperative exploration by manual palpation and ultrasonography revealed two more lesions. In the case of sporadically distributed lesions in the pancreas and if it is not possible to accurately differentiate those that represent the insulinoma for sure, the surgical procedure should be delayed. Additionally, tests such as selective arterial calcium stimulation testing should be carried out, and then, with more information in hands, make a re-plan of the potential surgical treatment which should be made.