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Mar 2022 DOI 10.14302/issn.2473-1005.jdoi-22-4136
Philip L. MillsteinCorresponding author
This methods paper describes a standardized approach for recording occlusal contacts in static and functional states. It outlines instrumentation, calibration, and interpretation steps aimed at improving reproducibility in clinical dentistry.
Sep 2020 DOI 10.14302/issn.2470-0436.jos-20-3400
Abo Taleb EmanCorresponding author
Regional hospital for vitreo. Retina and eye care at Sana'a, Yemen
Aim To compare the efficacy of combined anti-VGEF (IVB) with steroids versus pure anti-VEGF for the treatment of macular edema secondary to retinal vein occlusion (RVO). Methods In this prospective study, 51 eyes were randomized into 2 groups according to treatment of clinically identified macular edema secondary to retinal vein occlusion within 4 weeks of onset: Group 1 (19 eyes) was given intravitreal Bevacizumab (IVB) (1.25mg/.05ml) + Triamcinolone (IVTA) (2mg/.05ml); Group 2 (22 eyes) was given pure intravitreal Bevacizumab (IVB) (1.25mg/.05ml) at baseline, at month 1, and at month 2. The outcome of the study represented the EDRTS letters gain, IOP change and (CRT) by using Spectral domain optical coherence tomography (OCT) at month 1, 2, 3 and 6 in each group. Both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) patients with at least 6 months FU were enrolled in the study. Results EDRTS letters gain was (20.37±15.28, 28.05±16.68, 35.16±17.12, 36.47±18.17) in group1 and (14.50±14.56, 18.41±14.56, 20.59±16.13, 21.06±15.72) in group2 at month 2,3 and 6 p value (0.18, .04, 0.004, 0.002). Mean IOP pre-injection (14.00±2.67) in group 1 and (13.5±5.89) in group 2. Group 1 has transient increase in IOP at month 1 and then return to baseline over 6 months. CRT from baseline to final FU decrease by 264.82 (µm) ±147.66 in group 1 and 308.42(µm) ±226.78 in group 2 with no significant difference between two group p value 0.57. There was no significant difference in EDRTS letters gain between CRVO patients and BRVO patients at month 1, 2, 3 and 6 p values (0.83, 0.23, 0.29, 0.13). Conclusion Early treatment macular edema in RVO patients by combined anti-VGEF+ steroid effectively improve functional outcome better than pure anti-VGEF injection.
Oct 2019 DOI 10.14302/issn.2641-5518.jcci-19-3039
Sanikidze TamarCorresponding author
Tbilisi State Medical University, Tbilisi, Georgia
Chronic total occlusion (CTO) of the left main coronary artery (LMCA) is rare on the angiograms; Coronary Artery Bypass Grafting is the standard method of its revascularization. To demonstrate that PCI may in some cases be a safe option for patients with a high-risk surgical category, we report a complex clinical case of revascularization of chronic total occlusion of the LMCA, left anterior descending artery (LAD), and circumflex artery (CX). Methods Recanalization of the occluded LMCA and LAD was performed by utilizing the support-balloon technique, and CTO wires (Miracle 3™ wire, Abbott Vascular; Runthrough® NS Intermediate wire, Terumo); LAD, CX, LMCA, and its bifurcation, were stented with 3 drug-eluting stents (Resolute Integrity DES, Medtronic); the "Culotte Stenting " technique was used for bifurcation stenting, followed by "Kissing Balloon" post-dilatation technique; proximal optimization technique was performed in the LMCA. Results The intervention ended without complications. 2 months after stenting, the ejection fraction increased from 20% to 38%, improved almost all parameters of the heart, Congestive Heart Failure functional class decreased to class I. Conclusions It should be considered that LMCA CTO lesions can be successfully revascularized with PCI in case of the selection of the suitable patient and appropriate revascularization technique.
Sep 2019 DOI 10.14302/issn.2473-1005.jdoi-19-3042
Szuhanek CameliaCorresponding author
Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Victor Babes”, Timisoara
The treatment of class III malocclusion differs depending on the age of the patient. In adult patients, alternatives include either orthodontic dentoalveolar compensation treatment or a combined ortho-surgical approach. The aim of this paper is to present the orthodontic and surgical treatment of a 24 year old adult patient with increased anterior face height, a class III skeletal pattern and mandibular asymetry. Previous orthodontic treatment with removable appliances obtained a 1 mm overbite and overjet. Intraorally, class III molar relationship was observed, proclined upper incisors, retroclined lower incisors and a deviated lower midline. The main complaint was facial esthetics which required surgical intevention. After pre-surgical orthodontic preparation the maxilla was repositioned by a Le Fort I osteotomy and the mandible was set back using the Obwegeser-Dal Pont method. Final assesment revealed both functional and esthetic dentofacial results. A combination of orthodontic treatment and orthognathic surgery is often required in adult patients with dental malocclusion and skeletal discrepancies.
Aug 2017 DOI 10.14302/issn.2470-0436.jos-17-1721
C. Rodger DamienCorresponding author
USC Roski Eye Institute, Los Angeles, California
A 57-year-old Hispanic female presented with 3 days of blurry vision in the left eye. Eight years prior, she had a branch retinal artery occlusion in the right eye and a hematologic work-up revealed a 4G/4G polymorphism in plasminogen activator inhibitor-1. With the current episode, she was found to have bilateral branch retinal artery occlusions and mild vitritis in the left eye, simulating a toxoplasma infection. An infectious and inflammatory work up, however, was negative and the vitritis resolved after a short course of steroids. Plasminogen activator inhibitor-1 mutations may be associated with an increased risk of retinal vascular occlusions.
Jul 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1159
Yezdani ArifCorresponding author
Sree Balaji Dental College and Hospital.
This case report reiterates the fact that a bilateral posterior crossbite with severe skeletal class II malocclusion in the growth period could be effectively treated by a comprehensive approach with a rapid palatal expansion appliance followed by fixed appliance therapy. A 14-year-old boy presented with a severe skeletal Class II malocclusion with an orthognathic maxilla, retrognathic mandible and a high mandibular plane angle with an Angles’ Class II division 1 subdivision malocclusion with maxillary constriction, increased overjet, deep bite and severe crowding of maxillary and mandibular incisors. A banded rapid palatal expansion appliance was initially given to correct the bilateral posterior cross bite and subsequently maxillary and mandibular first premolars were extracted and Roths’ Pre adjusted edgewise appliance therapy (0.022 x 0.28-inch slot) was strapped up to correct the severe tooth size-arch length discrepancy. The patient’s soft tissue profile and dentofacial esthetics improved dramatically with increased self-confidence and enthused self-esteem.
Mar 2016 DOI 10.14302/issn.2329-9487.jhc-13-332
P. Desai ArpanCorresponding author
Interventional Cardiologist, Vadodara, Gujarat, India.
Objective: The objective of this study was to evaluate the efficacy of patent haemostasis in avoiding radial artery occlusion after transradial catheterization. Background: Radial artery occlusion is an infrequent but discouraging complication of transradial access. It is related to factors such as sheath to artery ratio and is less common in patients receiving heparin. Despite being clinically silent in most cases, it limits future transradial access. Patients and Methods: 130 patients undergoing transradial catheterization were prospectively enrolled in the study. 65 patients were randomized to group I, and underwent conventional pressure application for haemostasis. 65 were randomized to group II and underwent pressure application confirming radial artery patency using Barbeau’s test. Radial artery patency was studied at 24 hr and 30 days using Barbeau’s test. Results: There was Statistically significant difference found in rate of radial artery occlusion of both the groups at 24 hours (24.61% vs. 4.61% ,X2(1)=4.44, P<0.05) and at 30 days(20% vs. 3%,X2(1) =4.03, P < 0.05). Patients with Higher age and smaller radial artery diameter were at significantly higher risk of radial artery occlusion. No other procedural variables were found to be associated with radial artery occlusion. Conclusion: Patent haemostasis is highly effective in reducing radial artery occlusion after radial access and guided compression should be performed to maintain radial artery patency at the time of haemostasis, to prevent future radial artery occlusion.
Feb 2016 DOI 10.14302/issn.2379-8572.joa-14-531
Ota YasushiCorresponding author
Department of Otorhinolaryngology, Toho University Sakura Medical center, Japan
Central retinal artery occlusion (CRAO) is a retinal ischemic disorder associated with sudden loss of vision and has a poor prognosis. We report a case of CRAO that occurred during frontal sinus surgery involving craniotomy in a patient with a frontal sinus cyst. The prognosis for treatment after the acute phase is generally unfavorable; however, aggressive treatment is recommended for patients with visual acuity of “hand motion” or better within 1 day after onset. This case highlights the need for informed consent prior to nasal or paranasal sinus surgery, including mention of the possibility of CRAO as a complication.
Jun 2015 DOI 10.14302/issn.2470-0436.jos-14-528
Sanjay SrinivasanCorresponding author
Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
A previously healthy 25 year old Chinese male presented with left eye blurring of vision and was diagnosed to have left eye branch retinal vein occlusion. Initial blood investigations and thrombophilia screen were negative. The patient subsequently improved with observation and conservative management, with no further events over a 2 year follow up period. The blood investigations were repeated 2 years later as part of a health check-up and he was then tested to be heterozygous for the factor V leiden mutation. This was confirmed by sequencing of his genome that identified the mutation. The laboratory was contacted to provide details regarding the testing methods and was noted to have performed the two tests via different methods. While false negative rates in genetic testing are low, we believe that there is greater need to standardize testing methods as ascertaining genetic conditions play a great role in clinical diagnosis, treatment and prognosis. Clinicians should be aware of the limitations of these tests. When clinical suspicion is high, there may be a role for repeat tests with different methods or in different laboratories.
May 2015 DOI 10.14302/issn.2470-0436.jos-14-527
Sanjay SrinivasanCorresponding author
Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
A 66 year old Chinese male with a medical history of hypertension, diabetes mellitus and hepatitis B carrier was diagnosed with hepatocellular carcinoma in 2009. He underwent treatment with selective internal radiation spheres and sorafenib, and multiple cycles of chemotherapeutic agents such as bevacizumab, erlotinib, OXAFI ( intravenous oxaliplatin and doxorubicin given on days 1, 8 and 15 in a 28-day cycle, a daily continuous infusion of fluorouracil and subcutaneous interferon alfa-2b 5 million units administered thrice weekly), thalidomide, capecitabine, and rapamycin over the course of four years. Along the course of treatment, he developed pulmonary embolism and was initially started on anti-coagulation. Two months later, he developed hemoptysis and the anti-coagulants were stopped. During his routine ophthalmology visit for diabetic eye evaluation, he complained of blurring of vision of his left eye for the past four to five weeks. He was found to have central retinal vein occlusion (CRVO) of the left eye, associated with macular edema. Visual acuity was 6/15 for the right eye and 6/60 for the left eye. Eyelids, conjunctiva, cornea, anterior chamber, pupils, lens and ocular motility were normal. Humphrey visual field testing showed a superior arcuate and basal defect. This is the first reported case of CRVO in hepatocellular carcinoma. The etiology of CRVO is multifactorial, withhepatic malignancy, previous major surgery, multiple cycles of chemotherapy and cessation of anticoagulant therapyas possible aetiological factors. His background medical problems of diabetes and hypertension are further contributors.
Mar 2023
Md. Shafat KarimCorresponding author
Moyamoya disease is a very rare chronic circulatory occlusive disorder of the blood vessels of the brain, in which patients complain of headache, seizure, weakness, and sometimes paralysis. A 5 years old female child with a complaint of headache and seizure was admitted elsewhere and during the treatment, she was diagnosed with Moyamoya disease. Further, she went to AIIMS Patna, where the neurosurgeon advised Digital Subtraction Angiography (DSA) and after the final diagnosis, they suggest the surgical intervention of the brain. During the search for an alternative treatment, they consulted my center for Unani treatment. We advised a semiliquid Unani polyherbal formulation containing Gule Banafsha (Viola odorata), Ustukhuddoos(Lavandula stoechas), and Nilofer (Nymphaea alba Linn) for three months. After the completion of the treatment schedule, she went for DSA again in Patna AIIMS and they find that there is no sign of occlusion in the blood vessels of the brain. The patient has no complaints and the report also showed that she gets improved.
Jan 2023 DOI 10.14302/issn.2329-9487.jhc-22-4362
PIO MachihudeCorresponding author
Objective To describe the epidemiological, clinical and arterial Doppler ultrasound aspects of abdominal aortic aneurysm (AAA). Material and Methods This is a prospective study with descriptive and analytical aims carried out from January 2019 to March 2022 (3 years) at the cardiovascular exploration center (CEC) "Saint-Esprit" of the association of the people's doctors for the research on cardiovascular diseases (AMP-MCV), at the clinic "Le Printemps" and at the University Hospital of Kara. All patients who underwent arterial Doppler ultrasound of the lower limbs for any reason in these centers during the study period were included. Ultrasound scans were performed or confirmed by a physician with a diploma specializing in vascular Doppler ultrasound. Results We retained 32 Doppler ultrasound scans out of 739 performed for AAA with a frequency of 4.38%. The mean age was 73.5± 9.07 years. The sex ratio M/F was 1.4. The cardiovascular medical history (84.38%) found was: hypertension (33.33%), diabetes (18.52%), dyslipidemia (33.33%) and a combination of diabetes and hypertension (14.81%). The circumstances of discovery were: downstream MI ischemia (72%), incidental finding on abdominal ultrasound (15.63%) and De bakey sign (6.25%). The location of the aneurysms was subrenal (84.4%), suprarenal (9.4%) and both (6.2%). AAAs were fusiform (71.9%) and saccular (28.1%). The size of the aneurysms was greater than 5 cm in 78.17% of patients. High blood pressure increases the probability of the occurrence of subrenal AAA while dyslipidemia increases the occurrence of fusiform AAA. Diabetes increases the probability of occurrence of AAA larger than 7cm. AAAs were thrombosed in 75% of patients. There were extensions of the aneurysms to the iliac arteries in 70.59%. Downstream embolic complications represented 46.88%, in the form of occlusions and tight stenoses. Spontaneous mortality was 81.24%. Conclusion Arterial Doppler ultrasonography is a very important tool in the screening, positive and lesion diagnosis of AAA. The risk factors for AAA are: age over 60 years, male gender, hypertension, diabetes and dyslipidemia. Early detection remains essential, because the spontaneous prognosis is poor.
Dec 2020 DOI 10.14302/issn.2473-1005.jdoi-20-3659
C SzuhanekCorresponding author
Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy ‘Victor Babes’, Timisoara, Romania
Open bite malocclusion, due to it’s multifactorial etiology, has always been considered a difficult problem to treat. Often associated with transverse maxillary deficiency, this is a real challenge in the field of orthodontics. The traditional approach, for this type of anomaly, in adult patients, is orthognathic surgery and RME (rapid maxillary expansion). There are several approaches to the treatment of adult patients using digital technology. Mini-implant supported palatal expander limits the side effects of the conventional RME and is less invasive compared to orthognathic surgery. Precise and predictable mini-implant insertion, using a customized surgical guide, provides a safe therapeutic approach. This case report combines Cone-beam computed tomography (CBCT), laser scan superimposition, computer-aided design (CAD) and 3D printing in order to design and print a customized surgical guide for orthodontic mini-implant insertion. A CBCT scan was performed to determine the optimal site for mini-implants’ placement. Using the 3Shape Trios Intraoral Scanner the maxilla and the mandible were laser-scanned. Blue Sky Plan 4 software was used to design the surgical guide, and RayWare software was used for printing it. 4 mini-implants were inserted using a safe and predictable technique. The 3D technology represents the future of orthodontics, reducing the risks, chair-side time while providing the best treatment plan for the patient.
Apr 2018 DOI 10.14302/issn.2473-1005.jdoi-18-1968
Mauricio Ferraz da Silva JoaoCorresponding author
Av Eng Francisco Jose Longo ,77 12245000, Brazil.
Currently, patients seeking dental treatment are increasingly concerned with the esthetics. Accordingly, the professional must be able to indicate treatment approaches that often include more than one specialty. This concept of integrated dentistry allows achieving excellence in results, which may not be reached one single Dentistry specialty. In addition, the multidisciplinary dentistry enables the solution of cases more conservatively, especially cases where aesthetics is a relevant factor. This study aimed to report a clinical case showing esthetic disharmony of the anterior teeth even after the ending of the orthodontic treatment, causing dissatisfaction for both the patient and the dentist. From a functional point of view, the occlusion was adequate. However, the esthetics prevented a satisfactory outcome. To solve this issue, the case was treated through minimally-invasive ceramic laminates, then reaching the expected result.
Sep 2017
Chen JihuaCorresponding author
The goal of dental restoration is to restore and reconstruct the function, integrity, and morphology of missing tooth structures. At present, dental crowns are usually fabricated by referencing the homonym and adjacent teeth to design the morphology of the restoration, followed by empirical modifications on the restoration morphology. The original morphology of an intact natural tooth, if available, would allow for a balance of the horizontal and vertical forces generated by the surrounding tissues. Otherwise, it is hard for a restoration to reproduce the original tooth morphology. Discrepancies between original tooth morphology and restorations, such as axial over-contour or inappropriate occlusion, may break physiologically established balance, causing patient discomfort or even malocclusion and occlusal diseases. Therefore, to design and fabricate dental restorations with the original tooth morphology could be of great value to oral health. Literature indicates that physiological changes in tooth morphology slowly progress throughout one’s life. We present a hypothetical biomorphic dental restoration design that records the intact tooth morphology of a patient before lesions occur to allow for future design and fabricate of dental restorations. Using a copy of the pre-existing tooth abutment for restoration could result in none or fewer adjustments needed for restoration, and harmony with the surrounding tissues.
May 2017 DOI 10.14302/issn.2381-862X.jwrh-16-1374
Deligeoroglou EfthimiosCorresponding author
Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Obstetrics & Gynecology, University of Athens, Medical School, “Aretaieion” Hospital, Vasilissis, Sofias Avenue 76, 11528 Athens, Greece
Objectives: The aim of this study is to assess the correlation between the degree (percentage) of occlusion due to labial adhesions and vulvovaginitis. Materials and Methods: Prospective study of pre-pubertal females who attended our Division, during the past 7 years, due to labial fusion. Medical history, clinical examination and Q tip culture of vaginal fluid samples were performed, after separation of the labia. Treatment of isolated pathogens was administered, based on antibiogram results. Results: 53 patients, with mean age 3.81 years (±0.88 years, SD:2.65, range:0.33-9.5 years) had a total of 89 vaginal specimens collected, as re-culture was performed in 17 patients due to labial fusion recurrence. In 32.08% no pathogen was isolated. Gardnerella vaginalis (24.51%) and Bacteroides spp (15.09%) were the commonest isolated pathogens of the rest 67.92%. Among labial fusion recurrences the commonest isolated pathogen was Gardnerella vaginalis (23.13%), while in 36.12% no specific pathogen was detected. Conclusions: The results suggest that non-specific vulvovaginitis is responsible for lower degree (<60% closure) of labial adhesions, as well as that recurrent infection plays a role in the formation of higher degree/percentage of labial closure, especially when there are one or more pathogens present. Furthermore, the presence of anaerobes at initial cultures, together with Gram negative bacteria at re-cultures, appear to further facilitate the creation of extensive adhesions.
Jan 2017 DOI 10.14302/issn.2470-5020.jnrt-16-1415
W. Schrock JonCorresponding author
Associate Professor, Emergency Medicine Case Western Reserve University
Objectives: Computed tomography angiography (CTA) provides early assessment of cerebral vasculature in ED patients presenting with Acute Ischemic Stroke (AIS). Prior studies using 4 row detector CT scanners have suggested that results may be used to determine who receives thrombolytics (tPA). We sought to evaluate the rate of normal CTA and the use of tPA in AIS patients with and without blockages using modern CT technology. Patients and Methods: We conducted a retrospective cohort study of all code stroke patients presenting to our ED over a 3 year period. Inclusion criteria included an ED and neurology diagnosis of AIS with a CTA performed at presentation. All patients had a NIHSS score recorded at presentation and underwent imaging using a 64 row detector scanner with 50cc of non-ionic contrast. Demographic, imaging, and clinical data were collected. Modified Rankin Scores (mRS) were assigned at hospital discharge. Good clinical outcome was defined as a mRS of 0-2. Data are reported as frequencies and medians with interquartile ranges (IQR) as appropriate. Rates of tPA use were evaluated using χ2 testing. Rates of good outcomes were evaluated using odds ratios. Results: A total of 205 subjects met inclusion for analysis of which 103 (50%) were male and 109 (54%) had no blockage on CTA. The median NIHSS score and mortality rates were 14 (IQR 8-19), 14 (14%) with CTA blockage, and 4 (IQR 2-7), 2 (2%) for those without. Of those AIS with a blockage on CTA 46 (48%) were treated with tPA including 29 who were treated with intra-arterial therapy as well while only 13 (13%) of patients without a blockage were treated with tPA. Post tPA bleeding occurred in 12 (13%) patients with blockage on CTA and in 0 patients without blockage. Use of tPA was significantly more frequent in patients with a blockage on CTA, P <0.001. Conclusion: More than half of our AIS patients presenting through our ED have no blockage on CTA. Inter-rater reliability among neuroradiologists evaluating for large vessel occlusion appears to be very good. Patients with AIS and no blockage on CTA have less severe strokes and are less likely to receive tPA. Given the new guidelines recommending endovascular treatment for AIS we expect more emergency departments to begin performing CTA.
Nov 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1326
Szuhanek CameliaCorresponding author
Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Victor Babes”, Timisoara
This case report describes the treatment of a dento-alveolar protrusion with anterior open bite. The 21-year old patient had a convex profile , class I dental malocclusion , anterior open bite of 4 mm and presented tongue thrust. The treatment plan was to insert two mini-implants for premolar intrusion along with the straight –wire fixed appliances. Tongue therapy was performed by myofunctional exercises. Using the absolute anchorage we were able to achieve our goals in a predictable manner without the use of orthognathic surgery or patient compliance . After the tongue thrust habit was removed we are confident that this is a stable result .