Nevin Manimala

Oncol Res. 2024 Mar 20;32(4):785-797. doi: 10.32604/or.2024.047021. eCollection 2024.

ABSTRACT

Cytochromes P450 (CYPs) play a prominent role in catalyzing phase I xenobiotic biotransformation and account for about 75% of the total metabolism of commercially available drugs, including chemotherapeutics. The gene expression and enzyme activity of CYPs are variable between individuals, which subsequently leads to different patterns of susceptibility to carcinogenesis by genotoxic xenobiotics, as well as differences in the efficacy and toxicity of clinically used drugs. This research aimed to examine the presence of the CYP2B6*9 polymorphism and its possible association with the incidence of B-CLL in Egyptian patients, as well as the clinical outcome after receiving cyclophosphamide chemotherapy. DNA was isolated from whole blood samples of 100 de novo B-CLL cases and also from 100 sex- and age-matched healthy individuals. The presence of the CYP2B6*9 (G516T) polymorphism was examined by PCR-based allele specific amplification (ASA). Patients were further indicated for receiving chemotherapy, and then they were followed up. The CYP2B6*9 variant indicated a statistically significant higher risk of B-CLL under different genetic models, comprising allelic (T-allele vs. G-allele, OR = 4.8, p < 0.001) and dominant (GT + TT vs. GG, OR = 5.4, p < 0.001) models. Following cyclophosphamide chemotherapy, we found that the patients with variant genotypes (GT + TT) were less likely to achieve remission compared to those with the wild-type genotype (GG), with a response percentage of (37.5% vs. 83%, respectively). In conclusion, our findings showed that the CYP2B6*9 (G516T) polymorphism is associated with B-CLL susceptibility among Egyptian patients. This variant greatly affected the clinical outcome and can serve as a good therapeutic marker in predicting response to cyclophosphamide treatment.

PMID:38560574 | PMC:PMC10972729 | DOI:10.32604/or.2024.047021

Turk J Orthod. 2024 Mar 28;37(1):44-49. doi: 10.4274/TurkJOrthod.2023.2022.127.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the quality, reliability, and content usefulness of videos created by orthodontists on clear orthodontic aligners.

METHODS: Videos were screened using YouTube^TM by conducting a search for “Invisalign”. After a preliminary evaluation of the first 250 results, 61 videos that met the selection criteria were scored and their length, days since upload, and numbers of views, likes, dislikes, and comments were recorded. These data were used to calculate the interaction index and viewing rate. Video reliability was assessed using a five-item modified DISCERN index, and video quality was assessed using the Video Information and Quality Index. A 10-item content usefulness index was created to determine the usefulness of the video content. Descriptive statistics of the parameters were calculated, and correlation coefficients were calculated to evaluate the relationships between the parameters.

RESULTS: The mean reliability score was 2.75±1.02 (out of 5), and the total quality score was 11.80±3.38 (out of 20). The total content usefulness index was quite low, with a mean score of 2.52±2.14 (out of 10). Interaction index and viewing rate were positively correlated with reliability score (r=0.463, p<0.01; r=0.295, p<0.05) and total quality score (r=0.365, p<0.01; r=0.295, p<0.01, respectively). The reliability score was positively correlated with the total quality score (r=0.842, p<0.01) and total content usefulness index (r=0.346, p<0.01).

CONCLUSION: Videos about orthodontic aligner treatment have average reliability and quality but largely insufficient content.

PMID:38556952 | DOI:10.4274/TurkJOrthod.2023.2022.127

Turk J Orthod. 2024 Mar 28;37(1):36-43. doi: 10.4274/TurkJOrthod.2023.2022.20.

ABSTRACT

OBJECTIVE: To compare soft tissue profile variations between Class I and Class II adult patients due to three vertical skeletal facial patterns (normodivergent, hypodivergent and hyperdivergent) and determine which skeletal variation has the most significant impact on soft tissue profile.

METHODS: Retrospective soft tissue profile analysis was performed on lateral cephalograms of 131 adult patients. The analysis was divided into two categories correlated with subnasal and general soft tissue profiles. The sample was divided based on two sagittal skeletal patterns (Class I and II) and three vertical groups. In addition, comparisons were made between males and females. Viewbox 4 was used for the analysis. Descriptive, comparative, and correlation statistics were performed using SPSS software.

RESULTS: Statistically significant inter-gender differences were found at the subnasal profile level, but not at the general profile level. No significant differences were observed when comparing subnasal profiles for the sagittal groups. However, significant differences were observed at the level of the general profile, especially at the level of Z-angle, lower lip, and chin prominence. In the vertical groups, hyperdivergent facial patterns had significant differences at the level of subnasal and general profiles compared with other vertical facial patterns.

CONCLUSION: Females had more convex subnasal profiles than males. Hyperdivergent facial patterns had an impact on both general and subnasal soft tissue profiles. The sagittal dimension affected only the general soft tissue profile. Therefore, changes in the vertical dimension had the greatest impact on facial esthetics.

PMID:38556951 | DOI:10.4274/TurkJOrthod.2023.2022.20

Turk J Orthod. 2024 Mar 28;37(1):22-29. doi: 10.4274/TurkJOrthod.2023.2022.179.

ABSTRACT

OBJECTIVE: To investigate the most common retention practices, factors influencing the retention protocol, and the differences among orthodontists regarding retention practices.

METHODS: An online validated questionnaire was anonymously sent to 3,000 orthodontic residents and clinicians. The survey consisted of 19 questions regarding the participants’ demographics, prescribed retention appliances, factors affecting retention appliance choices, and adjunctive retention procedures. Descriptive statistics, Chi2 and Kendall’s Tau-b tests were applied.

RESULTS: Five hundred fifty-five orthodontic residents and clinicians, 53.3% males and 46.7% females, completed the survey, indicating a response rate of 18.5%. Although participants’ demographics, type of treatment and pre-treatment malocclusion influence the choice of retention protocols, thermoplastic retainers (TR) were the most popular retention regime for the maxillary arch for both adults (47.4%) and adolescents (42.3%). Bonded retainers (BR) were the favored option for the mandibular arch (44.9% of adults and 40.7% of adolescents). The degree of arch expansion (64.1%) and the degree of interdigitation (50.1%) after treatment were the most influential factors for the choice of the preferred type of retainers by the respondents. 68.6% of the participants thought professional retention guidelines would be useful.

CONCLUSION: Thermoplastic retainers were the most common retention appliances for adults and adolescents in the maxilla. At the same time, BR was the most favored retainer in the mandibular arch, with clinical experience, practice setting, and malocclusion- and treatment-related factors influencing the type of the chosen appliance. The demographic differences and the uneven participation in the survey need to be considered while interpreting the findings of this study.

PMID:38556949 | DOI:10.4274/TurkJOrthod.2023.2022.179

Turk J Orthod. 2024 Mar 28;37(1):14-21. doi: 10.4274/TurkJOrthod.2022.2022.78.

ABSTRACT

OBJECTIVE: The aim of this study was to determine how orthodontists utilize the social media application Instagram for health communication.

METHODS: Four Turkish keywords were manually searched on the Instagram platform on February 12, 2022: “orthodontist” (ortodontist), “orthodontics” (ortodonti), “orthodontic specialist” (ortodonti uzmanı), and “doctor of orthodontist” (ortodonti doktoru). A total of 195 orthodontist accounts matching the inclusion criteria were divided into two groups: public and private. Profile information analyses were performed, and the results for public and private accounts were compared. Public accounts were further divided by gender and whether they shared a company name in their profiles. Groups were compared according to post content and type of patient photo. Statistical analysis involved the Shapiro-Wilk test, an Independent Samples t-test, the Mann-Whitney U test, and chi-square and Kappa tests.

RESULTS: The number of posts (96.06±149.30 vs. 195.36±248.51) and followers (1,250.56±2,347.47 vs. 4,071.43±6,557.63) were higher for public accounts. The number of followers (3,171.62±4,645.08 vs. 5,472.57±8,595.99) and daily posts (0.17±0.37 vs. 0.23±0.43) were higher for accounts with a company name. In the content analysis, posts on clear aligners (1.51±4.74 vs. 6.60±18.60, p<0.05) and patient and company advertisements were more common (0.49±1.85 vs. 3.70±10.70, p<0.05) for accounts with a company name.

CONCLUSION: While public orthodontist accounts commonly promote fixed mechanics as a treatment option, accounts with a company name adopt a different approach, emphasizing the sharing of information about clear aligners.

PMID:38556948 | DOI:10.4274/TurkJOrthod.2022.2022.78

Turk J Orthod. 2024 Mar 28;37(1):1-6. doi: 10.4274/TurkJOrthod.2023.2022.158.

ABSTRACT

OBJECTIVE: To compare the consistency of two interproximal reduction (IPR) methods in terms of the amount of planned and performed IPR during clear aligner therapy (CAT).

METHODS: Thirty-four patients who received IPR using hand-operated abrasive strips (Group 1, 20 patients, 162 teeth) and motor-driven 3/4 oscillating segmental disks (Group 2, 14 patients, 134 teeth) during CAT were included in this preliminary study. The consistency between the planned and performed IPR amounts was evaluated within and between groups for teeth and quadrants.

RESULTS: In Group 1, the amount of IPR performed on teeth numbers 22 and 43 and in the upper left quadrant was found to be statistically less than that of planned. On the other hand, the amount of performed IPR was statistically higher on tooth number 44 and in the upper right quadrant, whereas it was statistically less on tooth number 33 when compared with the planned amount in Group 2. The inconsistency between the planned and performed IPR amounts were statistically significant only in Group 1 and for teeth numbers 11, 21, 32, 33, and 43. No significant difference was found when the same parameter was compared between the groups.

CONCLUSION: The consistency of IPR was found to be better with the motor-driven oscillating disk system than with the hand-operated IPR strip system.

PMID:38556946 | DOI:10.4274/TurkJOrthod.2023.2022.158

Acute Crit Care. 2024 Apr 1. doi: 10.4266/acc.2023.00983. Online ahead of print.

ABSTRACT

BACKGROUND: Itolizumab downregulates the synthesis of proinflammatory cytokines and adhesion molecules by inhibiting CD6 leading to lower levels of interferon-γ, interleukin-6, and tumor necrotic factor-α and reduced T-cell infiltration at inflammatory sites. This study aims to compare the effects of tocilizumab and itolizumab in the management of severe coronavirus disease 2019 (COVID-19).

METHODS: The study population was adults (>18 years) with severe COVID-19 pneumonia admitted to the intensive care unit receiving either tocilizumab or itolizumab during their stay. The primary outcome was clinical improvement (CI), defined as a two-point reduction on a seven-point ordinal scale in the status of the patient from initiating the drug or live discharge. The secondary outcomes were time until CI, improvement in PO2/FiO2 ratio, best PO2/FiO2 ratio, need for mechanical ventilation after administration of study drugs, time to discharge, and survival days.

RESULTS: Of the 126 patients included in the study, 92 received tocilizumab and 34 received itolizumab. CI was seen in 46.7% and 61.7% of the patients in the tocilizumab and itolizumab groups, respectively and was not statistically significant (P=0.134). The PO2/FiO2 ratio was significantly better with itolizumab compared to tocilizumab (median [interquartile range]: 315 [200-380] vs. 250 [150-350], P=0.043). The incidence of serious adverse events due to the study drugs was significantly higher with itolizumab compared to tocilizumab (14.7% vs. 3.3%, P=0.032).

CONCLUSIONS: The CI with itolizumab is similar to tocilizumab. Better oxygenation can be achieved with itolizumab and it can be a substitute for tocilizumab in managing severe COVID-19.

PMID:38556909 | DOI:10.4266/acc.2023.00983

BMC Infect Dis. 2024 Apr 1;24(1):364. doi: 10.1186/s12879-024-09238-8.

ABSTRACT

BACKGROUND: The emergence of Drug Resistant Tuberculosis (DR-TB) is one of the main public health and economic problems facing the world today. DR-TB affects mostly those in economically productive years and prevents them from being part of the workforce needed for economic growth. The aim of this study was to determine the Clinical Profile and Outcomes of DR-TB in Central Province of Zambia.

METHODS: This was a retrospective cross sectional study that involved a review of records of patients with confirmed DR-TB who were managed at Kabwe Central Hospital’s Multi-Drug Resistant TB (MDR-TB) Ward from the year 2017 to 2021. 183 patients were managed during this period and all were recruited in the study. Data was collected from DR-TB registers and patient files and then entered in SPSS version 22 where all statistical analyses were performed.

RESULTS: The study revealed that the prevalence of DR-TB among registered TB patients in Central Province was 1.4%. Majority of those affected were adults between the ages of 26 and 45 years (63.9%). The study also found that more than half of the patients were from Kabwe District (60.7%). Other districts with significant number of cases included Kapiri Mposhi 19 (10.4%), Chibombo 12 (6.6%), Chisamba 10 (5.5%), Mumbwa 7 (3.8%) and Mkushi 7 (3.8%). Furthermore, the analysis established that most of the patients had RR-TB (89.6%). 9.3% had MDR-TB, 0.5% had IR-TB and 0.5% had XDR-TB. RR-TB was present in 93.8% of new cases and 88.9% of relapse cases. MDR-TB was present in 6.2% of new cases and 10% of relapse cases. With regard to outcomes of DR-TB, the investigation revealed that 16.9% of the patients had been declared cured, 45.9% had completed treatment, 6% were lost to follow up and 21.3% had died. Risk factors for mortality on multivariate analysis included age 36-45 years (adjusted odds ratio [aOR] 0.253, 95% CI [0.70-0.908] p = 0.035) and male gender (aOR 0.261, 95% CI [0.107-0.638] p = 0.003).

CONCLUSION: The research has shown beyond doubt that the burden of DR-TB in Central Province is high. The study recommends putting measures in place that will help improve surveillance, early detection, early initiation of treatment and proper follow up of patients.

PMID:38556907 | DOI:10.1186/s12879-024-09238-8

Chin Neurosurg J. 2024 Apr 1;10(1):9. doi: 10.1186/s41016-024-00361-8.

ABSTRACT

BACKGROUND: Cranial nerve palsy (CNP) is a common complication of traumatic brain injury (TBI). Despite a high incidence of TBI in Nepal (382 per 100,000), literature on the specific management and outcome of CNP is lacking. This study aimed to examine the outcomes of TBI patients involving single versus multiple CNP.

METHODS: A retrospective chart review of 170 consecutive TBI patients admitted to the tertiary neurosurgical center in Nepal between April 2020 and April 2022 was conducted. Demographic, clinical, and etiological characteristics; imaging findings; and management strategies were recorded, compared, and analyzed using descriptive statistics. The Glasgow Outcome Scale Extended (GOSE) was used to measure the outcomes in two groups of patients (single and multiple CNP) at 3 months.

RESULTS: Out of 250 eligible patients, 80 were excluded and CNP was noted in 29 (17.1%) of the remaining 170. The median age was 34.9 years, and falls (60.6%) were the most common cause of trauma. TBI severity was categorized based on GCS: mild (82.4%), moderate (15.9%), and severe (1.8%). Cranial nerve involvement was seen in 29 (17.05%) patients: single cranial nerve involvement in 26 (89.65%) and multiple nerve involvement in 3 (10.34%). The most common isolated cranial nerve involved was the oculomotor nerve (37.9%). CT findings revealed a maximum of skull fractures with no significant association between CNP and CT findings.

CONCLUSIONS: CNP is a common consequence of TBI with the most common etiology being falls followed by RTA. Single CNP was more common than multiple CNP with no significant difference in the outcome in the 3-month GOSE score. Further research is needed to determine the burden of traumatic CNP and establish specific management guidelines for different types of CNP.

PMID:38556895 | DOI:10.1186/s41016-024-00361-8

Clin Implant Dent Relat Res. 2024 Mar 31. doi: 10.1111/cid.13324. Online ahead of print.

ABSTRACT

BACKGROUND: Using the sandwich osteotomy technique in the posterior mandible is delicate. This study aimed to assess the safety and the amount of bone gain using a full digital workflow versus the conventional procedure.

PATIENTS AND METHODS: This split mouth study included 10 patients with bilateral vertically deficient posterior mandible. One side received conventional sandwich interpositional bone grafting (control group), while the other side received the same protocol using two patient-specific guides. The first guide (cutting guide) was used to place the osteotomies safely and accurately according to the predetermined dimensions and locations, and the second guide was used to fix the mobilized bony segment, leaving the desired gap to be filled with a particulate xenogenic bone graft.

RESULTS: Full neurosensory recovery was documented at 2 months postoperative for all patients and bilaterally. After 4 months, there was a statistically significant difference in vertical bone gain between both groups (p = 0.001), measuring an average of 3.76 ± 0.72 mm in the study group and 2.69 ± 0.37 mm in the control group. No statistically significant difference was found between the planned vertical augmentation (3.85 ± 0.58 mm) and the obtained vertical bone gain (3.76 ± 0.72 mm) in the study group (p = 0.765) proving the accuracy of the guided procedure.

CONCLUSION: Computer-guided sandwich interpositional grafting is predictable regarding the execution of the osteotomies and the accuracy of fixation of the transport segment.

PMID:38556885 | DOI:10.1111/cid.13324