Nevin Manimala

Pol Merkur Lekarski. 2024;52(1):42-48. doi: 10.36740/Merkur202401107.

ABSTRACT

OBJECTIVE: . Aim: To study the stability of surface-modified dental implants, with the usage of sandblasting/acid modification vs. photoactivation.

PATIENTS AND METHODS: Materials and Methods: In the observation were included 164 patients with dental defects. All patients had digital impressions taken by scanning the oral cavity with an intraoral scanner 3Shape TRIOSR. Group A (80 subjects) included implants whose surface was modified with a combination of sandblasting and acid. Group B (84 subjects) – implants after modification with photoactivation. The implant stability quotient was recorded using an Osstell MentorTM device.

RESULTS: Results: The reliable effectiveness of the photoactivation method in complex treatment of the surface of dental implants in improving the stability of fixed dentures in the short and long-term periods of observation was proven. When assessing immediate clinical outcomes, there was no significant difference in the frequency of hyperemia, algesia, hyperthermia, soft tissue edema, regional lymphadenitis, depending on the classical method of treating the implant surface and the complex method with photoactivation. Of the long-term clinical outcomes with classical surface treatment, the absolute risk of implant failure was 1.2%, relative risk – 0,99 [CI%0,96-1,0]. The average value of the implant stability coefficient (ISQ) and the data of the Periotest study at the time of surgery probably did not differ in the observation groups, after 3 months, a higher index was proven in the treatment of the surface by the method of photoactivation and greater stability of the mandibular implants. At the time of implantation, there were no statistically significant differences in implant fixation between the groups, however, during prospective observation in group A, secondary stability indicators based on periotestometry results were significantly lower.

CONCLUSION: Conclusions: It was proved the reliable effectiveness of the photoactivation-method for surface modification in the short and long-term periods of observation for improving the results of orthodontically treatment.

PMID:38518232 | DOI:10.36740/Merkur202401107

Pol Merkur Lekarski. 2024;52(1):23-29. doi: 10.36740/Merkur202401104.

ABSTRACT

OBJECTIVE: Aim: The aim of the present published work is efficacy evaluation of the modified educational program in achieving the target levels of glycemia in children and adolescents with type 1 diabetes mellitus in pump insulin therapy in Almaty..

PATIENTS AND METHODS: Materials and Methods: This study involved 125 children and adolescents with type 1 DM and evaluated the effectiveness of a modified educational program at the School of Type 1 Diabetes Mellitus. Participants were divided into subgroups based on their method of glycemia evaluation. The program’s effectiveness was assessed through pre-and post-training questionnaires and measurement of glycohemoglobin levels. Statistical analysis was conducted using the Statistica application.

RESULTS: Results: The study evaluated the effectiveness of a modified educational program for children and adolescents with type 1 DM. The results indicated that those who participated in the modified program demonstrated significant improvements in their knowledge and ability to manage their diabetes. They were able to correctly answer 80-90% of the questionnaire questions six months to a year after the training. Additionally, those in the modified program exhibited better carbohydrate metabolism rates and achieved higher rates of their individual treatment goals, especially when using the FreeStyle Libre system for continuous monitoring of blood glucose levels. These findings suggest that a modified educational approach can significantly enhance diabetes management and treatment outcomes in children and adolescents.

CONCLUSION: Conclusions: The study concluded that a modified educational program leads to better target therapy levels in children and adolescents with type 1 diabetes mellitus, highlighting the importance of motivated parents and frequent blood glycemia measurements.

PMID:38518229 | DOI:10.36740/Merkur202401104

J Low Genit Tract Dis. 2024 Apr 1;28(2):164-168. doi: 10.1097/LGT.0000000000000796. Epub 2024 Jan 10.

ABSTRACT

OBJECTIVES: Lichen sclerosus (LS) is an inflammatory skin disease probably arising from an interplay of genetics, local irritation, and autoimmune processes. We identified potential risk factors for the disease using data from nationwide Finnish registries.

METHODS: We identified all women diagnosed with LS within specialized health care during 1998-2016 (n = 10,692) and selected 3 age-matched population control women for each case. We calculated odds ratios (ORs) for possible risk factors using conditional logistic regression.

RESULTS: Dermatological autoimmune conditions were strongly associated with LS (OR = 15.1, 95% confidence interval [CI] = 13.6-16.7 for morphea; OR = 10.3, 95% CI = 5.02-19.0 for lichen planus; OR = 6.86, 95% CI = 5.65-8.33 for alopecia; OR = 2.20, 95% CI = 1.88-2.56 for vitiligo). A diagnosis of Crohn or celiac disease increased the odds of LS (OR = 1.80, 95% CI = 1.71-1.89; OR = 1.49, 95% CI = 1.28-1.73, respectively) as did urge and stress incontinence (OR = 1.79, 95% CI = 1.71-1.87; OR = 1.28, 95% CI = 1.22-1.35, respectively).The odds of LS were lower in women after a diagnosis of type 1 diabetes (OR = 0.43, 95% CI = 0.41-0.45), coronary artery disease (OR = 0.41, 95% CI = 0.38-0.43), and rheumatoid arthritis (OR = 0.38, 95% CI = 0.36-0.41).Parous women had higher odds of LS (OR = 1.11, 95% CI = 1.04-1.17) than nulliparous ones, but increasing number of births decreased the risk. Lichen sclerosus was not associated with socioeconomic status nor the urbanicity level of the place of residence.

CONCLUSIONS: Certain autoimmune diseases and urinary incontinence were associated with LS.

PMID:38518214 | DOI:10.1097/LGT.0000000000000796

Cephalalgia. 2024 Mar;44(3):3331024231226196. doi: 10.1177/03331024231226196.

ABSTRACT

BACKGROUND: Hemicrania continua (HC) and paroxysmal hemicrania (PH) belong to a group of primary headache disorders called trigeminal autonomic cephalalgias. One of the diagnostic criteria for both HC and PH is the absolute response to the therapeutic dose of indomethacin. However, indomethacin is discontinued in many patients as a result of intolerance to its side effects. Melatonin, a pineal hormone, which shares similar chemical structure to indomethacin, has been reported to have some efficacy for HC in previous case reports and series. To our knowledge, there is no literature regarding the use of melatonin in PH. We aimed to describe the clinical use of melatonin in the preventive management of HC and PH.

METHODS: Patient level data were extracted as an audit from routinely collected clinical records in consecutive patients seen in outpatient neurology clinic at King’s College Hospital, London, UK, from September 2014 to April 2023. Our cohort of patients were identified through a search using the keywords: hemicrania continua, paroxysmal hemicrania, melatonin and indomethacin. Descriptive statistics including absolute and relative frequencies, mean ± SD, median and interquartile range (IQR) were used.

RESULTS: Fifty-six HC patients were included with a mean ± SD age of 52 ± 16 years; 43 of 56 (77%) patients were female. Melatonin was taken by 23 (41%) patients. Of these 23 patients, 19 (83%) stopped indomethacin because of different side effects. The doses of melatonin used ranged from 0.5 mg to 21 mg, with a median dose of 10 mg (IQR = 6-13 mg). Fourteen (61%) patients reported positive relief for headache, whereas the remaining nine (39%) patients reported no headache preventive effect. None of the patients reported that they were completely pain free. Two patients continued indomethacin and melatonin concurrently for better symptom relief. Eight patients continued melatonin as the single preventive treatment. Side effects from melatonin were rare. Twenty-two PH patients were included with mean ± SD age of 50 ± 17 years; 17 of 22 (77%) patients were female. Melatonin was given to six (27%) patients. The median dose of melatonin used was 8 mg (IQR = 6-10 mg). Three (50%) patients responded to melatonin treatment. One of them used melatonin as adjunctive treatment with indomethacin.

CONCLUSIONS: Melatonin showed some efficacy in the treatment of HC and PH with a well-tolerated side effect profile. It does not have the same absolute responsiveness as indomethacin, at the doses used, although it does offer a well-tolerated option that can have significant ameliorating effects in a substantial cohort of patients.

PMID:38518183 | DOI:10.1177/03331024231226196

Altern Ther Health Med. 2024 Mar 22:AT9833. Online ahead of print.

ABSTRACT

BACKGROUND: Low anterior resection syndrome (LARS) is a post-proctectomy consequence characterized by variable and unpredictable bowel function, including clustering, urgency, and incontinence, which significantly impacts the quality of life. Currently, there is no established gold-standard therapy for LARS.

PRIMARY STUDY OBJECTIVE: This study aimed to evaluate the effectiveness of the Paula method of exercise as part of an integrative treatment approach for patients with LARS.

DESIGN: This preliminary study utilized a single-arm pretest-posttest design.

SETTING: The study was conducted at a tertiary care medical center.

PARTICIPANTS: Five patients diagnosed with LARS completed the study.

INTERVENTION: Participants underwent twelve weeks of individualized Paula method exercise sessions. Two questionnaires were employed to assess the severity of LARS and quality of life.

PRIMARY OUTCOME MEASURES: (1) Low Anterior Resection Syndrome (LARS) Score; (2) Memorial Sloan Kettering Cancer Bowel Function Instrument (MSK-BFI); (3) Global Quality-of-Life (QOLS) Score ‎.

RESULTS: All participants completing the 12-week Paula exercise regimen reported no difficulty in engaging with the exercises. Statistically significant improvements were observed in both the LARS score and MSK-BFI (P = .039 and P = .043, respectively, Wilcoxon Rank Sum test). While there were improvements in the global quality-of-life score and functional scales of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, these improvements did not reach statistical significance.

CONCLUSIONS: This preliminary study suggests that patients with LARS can successfully complete a 12-week exercise program using the Paula method, resulting in improved LARS scores. However, further investigation through larger, multicenter, randomized controlled trials is necessary to establish the efficacy of these exercises as a treatment for LARS.

PMID:38518172

Altern Ther Health Med. 2024 Mar 22:AT7604. Online ahead of print.

ABSTRACT

BACKGROUND: In cesarean delivery, factors such as general anesthesia affect bowel function, leading postpartum women to experience abdominal tenderness, gas, and constipation.

OBJECTIVE: This study aims to assess the impact of acupressure on bowel function after cesarean delivery.

DESIGN: A randomized-controlled experimental study was conducted.

PARTICIPANTS: The study population comprised postpartum women who underwent cesarean delivery at Ondokuz Mayıs University Health Practice and Research Hospital between July 2021 and January 2022. The sample consisted of 61 postpartum women (acupressure group: 31, control group: 30).

INTERVENTION: Participants were divided into two groups: the acupressure group and the control group. Women in the acupressure group received 14 minutes of acupressure application to the LI4 and TH6 points twice, once within the first postoperative hour and again three hours later. The control group received no acupressure intervention.

OUTCOME MEASURES: Data were collected using a Postpartum Information Form and a Post-cesarean Follow-up Form. Statistical analyses included the Mann-Whitney U test, Student’s t test, and chi-squared analysis.

RESULTS: The mean age of postpartum women in the acupressure group was 27.61±4.39, while in the control group, it was 28.50±3.85. The mean times for bowel sounds, flatulence, and bowel movements in the acupressure group (9.98±2.77, 19.43±10.25, and 27.13±10.77 hours, respectively) were significantly shorter than those in the control group (14.41±5.07, 23.33±4.20, and 46.16±17.95 hours, respectively) (P < .05).

CONCLUSIONS: Acupressure was found to be effective in improving bowel function after cesarean delivery, significantly reducing the time taken for participants to experience bowel sounds, flatulence, and bowel movements.

PMID:38518170

Altern Ther Health Med. 2024 Mar 22:AT7352. Online ahead of print.

ABSTRACT

Trichomonas tenax is an oral protozoan with an estimated global pooled prevalence of 17% in the human population.1 Observational studies have demonstrated a significant statistical correlation between oral colonization by T. tenax and the progression of periodontal disease.2 Proposed pathogenic mechanisms for this protozoan include the production of tissue-damaging enzymes, induction of apoptosis in human cells, and dysbiosis of the oral microbiome.3 In patients for whom metronidazole (MTZ) is contraindicated, phytochemicals may offer a viable alternative for controlling T. tenax. Various plant extracts have shown promising in vitro activity against other trichomonads, such as T. vaginalis and Tritrichomonas foetus, as reviewed by Friedman et al.4.

PMID:38518169

Altern Ther Health Med. 2024 Mar 22:AT10335. Online ahead of print.

ABSTRACT

OBJECTIVE: We studied the efficacy and safety of traditional Chinese medicine paiteling treatment of persistent human papillomavirus (HPV) infection in males.

METHODS: The study included 159 male patients with persistent HPV infection between January 2018 and July 2022, and categorized into the treatment group (n = 96) and control group (n = 63) based on the treatment. The treatment group was externally treated with paiteling diluent for 4 consecutive days and then stopped for 3 days. The total course of treatment was one month. The treatment group underwent a second test six months after treatment. The control group did not receive any therapy and underwent a second test in the seventh month.

RESULTS: 19 of the 159 patients were lost during the 6-month follow-up period, leaving 140 patients. The male HPV infection peaks between the ages of 26-35 years 73(52.14%), and its prevalence decrease with age. 84 (60.0%) were single type infections, and 22 (15.71%) had at least 3 types infections. There were 76 (54.29%) patients with the high-risk types, 34 (24.29%) with the low-risk types, and 30 (21.43%) with the mixed types. After 6 months, complete negative conversion rates and negative conversion rates were 74.7% and 90.8% in the treatment group respectively, compared to the control group (P < .01). A comparison of negative conversion rates among different types reveals that 16 type (89.5%) and 6 type (92.3%) had statistical differences, (P < .01) and (P < .05) respectively. Multivariate analysis revealed that the vaccine status of sexual partners was a protective factor (OR = 0.050-0.848) and multi-type infection was a risk factor (OR = 1.807-22.527) for the curative effect.

CONCLUSION: Paiteling is convenient, safe, and effective for the treatment of persistent HPV infection in males.

PMID:38518163

Altern Ther Health Med. 2024 Mar 22:AT10322. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically assess the impact of prone position ventilation on hypoxemia in patients following extracorporeal cardiac surgery and to establish a reference for further clinical investigation into effective post-surgery mechanical ventilation positions.

METHODS: A meta-analysis was conducted through extensive database searches, focusing on randomized controlled trials of cardiopulmonary bypass in hypoxic patients meeting specific inclusion and exclusion criteria. A total of 8 papers involving 442 patients were finally included in this study.

RESULTS: The meta-analysis revealed that the oxygenation index was significantly higher in the prone position ventilation group compared to the supine position ventilation group [MD=51.24, 95% CI (46.14, 56.35), P < .001]. The partial pressure of oxygen in prone patients was also significantly higher than in supine patients [MD=-2.96, 95% CI (1.78, 4.14), P < .001]. Regarding oxygen saturation, blood oxygen saturation in the prone position group surpassed that in the supine position group, showing a statistically significant difference [MD=4.81, 95% CI (3.83, 5.79), P < .001]. Additionally, patients ventilated in the prone position exhibited a shorter duration of mechanical ventilation compared to those in the supine position, with a statistically significant difference [MD=-57.31, 95% CI (-66.57, -48.06), P < .001].

CONCLUSIONS: In the absence of significant hemodynamic changes, prone position ventilation significantly enhances the oxygenation index and reduces the duration of mechanical ventilation in patients undergoing extracorporeal circulation surgery. However, the observed heterogeneity across studies may be attributed to variations in breathing styles, respiratory techniques, and physiological parameters among different patient groups.

PMID:38518160

Altern Ther Health Med. 2024 Mar 22:AT10313. Online ahead of print.

ABSTRACT

OBJECTIVE: Maxillofacial-neck hyperplastic scars have long been a persistent concern among individuals in both Western and Eastern countries. These scars exhibit rapid growth within 3-6 months following wound healing, subsequently receding at a slower pace, leading to skin redness, tension, and potential itching. The lack of comprehensive understanding regarding the formation mechanism and biological attributes of these scars has made them a prominent subject of research both domestically and internationally.

METHODS: Research data from 2010 to 2023 was selected, and relevant literature on the efficacy of botulinum toxin in the treatment of facial and neck hypertrophic scars was searched until August 2023. The literature on the incidence of facial-neck hypertrophic scars included in PubMed, the Cochrane Library, EMbase, and Web of Science was searched. Two researchers independently screened and extracted the data according to strict inclusion and exclusion criteria.Risk bias in Review Manager 5.4, provided by the Cochrane Collaboration, was used for methodological quality assessment and meta-analysis of the included literature. In case of any disagreement, the decision shall be made through consultation with the third party. Scar width, patient satisfaction, and visual analogue scale (VAS) were evaluated. Weighted mean difference (WMD), odds ratio (OR), and 95% confidence interval (95%CI) were used for evaluation. Publication bias was intuitively determined by funnel plot, and sensitivity analysis was conducted by removing literatures one by one for risk assessment.

RESULTS: After reading the title, abstract, and full text, a total of 237 patients were included in 7 articles. Scar width was only studied in 6 literatures, and the heterogeneity test of the included studies (χ2 = 148.95, P < .001, I2 = 98%) showed significant heterogeneity among the studies. Therefore, the random effects model was used to merge the data. Combined effect value WMD =-2.85 [95% CI :(-6.51, 0.81), P < .001], the difference between the two groups was statistically significant. The combined OR of the random-effects model was 8.52 [95%CI: (7.96, 9.08), P < .001], and the difference between the two groups was statistically significant. Among them, the heterogeneity test (χ2 = 2.69, P = .44, I² = 0%) was carried out in two studies, indicating good homogeneity among the studies, so the combined WMD was 0.68 [95%CI: (0.38, 0.99), P < .001] by using the fixed-effect model. The median VAS was described in the other two literatures, and the mean scores in the experimental group were 8.9 and 8.25, respectively, while the mean scores in the control group were 7.2 and 6.28, respectively, indicating that local injection of botulinum A toxin at the early stage of wound healing can significantly improve scar quality. Sensitivity analysis suggested that the meta-analysis results were stable and reliable, and publication bias was not analyzed using funnel plots.

CONCLUSION: Botulinum toxin has a positive effect on preventing hyperplastic scars in the maxillofacial and neck areas, and it can also help fade existing scars.

PMID:38518155