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Comparison of Fracture Resistance of Different Reattachment Techniues and Adhesive Materials on Incisal Tooth Fragment Reattachment 不同再附着技术及黏附材料在切牙碎片再附着中的抗折性比较
Pub Date : 2017-07-01 DOI: 10.9790/0853-160603133138
Anshuka A. Agrawal, Saloni Agrawal, Devender Kumar Sharma, M. Bansal, Vipul Choudhary, K. Moolchandani
Purpose: This is an in vitro study to compare fracture resistance of different reattachment techniques and adhesive materials on incisal tooth fragment reattachment. Methodology: 100 sound human maxillary central incisors were selected .10 were maintained as a control group. Remaining 90 were divided randomly into 3 groups (n=30) based upon the materials used for reattachment and further divided into 3 subgroups (n=10) on the basis of different reattachment techniques. The materials used are dual cure resin cement, flowable composite, nano hybrid composite and three different reattachment techniques used were simple reattachment , overcontour and internal dentinal groove. Data was analyzed with ANOVA (One-Way) test and Post-Hoc Bonferroni test. Results: The control group had a significantly higher fracture resistance (p= 0.001); the highest fracture resistance values were obtained by Dual cure resin cement followed by Nano hybrid composite and minimum in Flowable composite .When compared between three different reattachment techniques internal dentinal groove showed the maximum fracture resistance followed by over contour technique and minimum showed the simple reattachment technique. Conclusion: Although, none of the tested materials provided fracture resistance similar to that found with the intact maxillary central incisors, utilizing the dual cure resin cement improved the fracture resistance of the reattached fragment than other materials.
目的:比较不同的牙块再附着技术和黏附材料对切牙碎片再附着的抗骨折性。方法:选择100例健全人上颌中切牙,保留10例作为对照组。其余90例按再附着材料随机分为3组(n=30),按再附着方式随机分为3个亚组(n=10)。使用的材料有双固化树脂水泥、可流动复合材料、纳米混合复合材料和三种不同的修复技术:简单修复、过轮廓修复和牙本质内槽修复。数据分析采用单因素方差分析(ANOVA)检验和事后Bonferroni检验。结果:对照组患者抗骨折能力显著高于对照组(p= 0.001);双固化树脂水泥的断裂阻力最大,其次是纳米复合材料,流动复合材料的断裂阻力最小。三种不同的牙本质槽再植方式的断裂阻力最大,其次是超轮廓再植方式,简单再植方式的断裂阻力最小。结论:虽然所有材料的抗骨折性都不如上颌中切牙完整时,但使用双固化树脂骨水泥比其他材料更能提高再附着碎片的抗骨折性。
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引用次数: 2
Fixation of Subtrochantric Fractures Using Distal Femoral Locking Compression Plate of Contralateral Side 对侧股骨远端锁定加压钢板固定粗隆下骨折
Pub Date : 2017-07-01 DOI: 10.9790/0853-1607013945
Roel Langshong, B. Punithavasanthan, Pheiroijam Bhupes, S. Singh, Rajkumar Debbarma, P. S. Prashanth, P. rai, Shams Gulrez, Dilip Soring, Temjen sunep
Introduction: Different implants are available to internally fix subtrochantric fracture of femur, due to anatomical & biomechanical reasons, the sub-trochanteric femoral fracture still a challenge for Orthopaedic Surgeons Objective: The purpose of this study was to evaluate the outcome in early treatment of subtrochanteric fractures of femur with distal femoral locking compression plate of contralateral side. Methods: Thirty patients were included in this study. Sixteen patients (53.3%) had AO type 32B fracture, while nine patients (30%) and five patients (16.6%) were classified as AO type 32A and 32C respectively. Road traffic accidents accounted for 21 patients (70%). Mean follow-ups were 11 ±6 months (range 6 to 19 months). 27 fractures (90%) achieved union, average union time in 14.5 weeks Ranging from 10 weeks to 20 weeks. while three patients (10%) had complications. In one patient the plate had broken, one had broken screw and nonunion of the fracture. At the end of the follow-ups, 29 patients (96.6%) were community ambulators.The Modified Harris hip score (MMHS) was used to evaluate the functional outcome of surgery Conclusion: We conclude that distal femoral locking compression plate of contra lateral side is as effective as PF-LCP and is an effective alternative treatment for subtrochanteric fractures when properly performed.
导读:股骨粗隆下骨折的内固定有不同的植入物,但由于解剖学和生物力学的原因,股骨粗隆下骨折的内固定仍然是骨科医生面临的一个挑战。目的:本研究的目的是评估对侧股骨远端锁定加压钢板早期治疗股骨粗隆下骨折的效果。方法:选取30例患者作为研究对象。AO 32B型骨折16例(53.3%),AO 32A型9例(30%),AO 32C型5例(16.6%)。道路交通事故占21例(70%)。平均随访11±6个月(6 ~ 19个月)。27例骨折愈合(90%),平均愈合时间14.5周,愈合时间从10周到20周不等。3例(10%)出现并发症。1例患者钢板断裂,1例患者螺钉断裂,骨折不愈合。随访结束时,29例患者(96.6%)使用社区救护车。结论:对侧股骨远端锁定加压钢板与PF-LCP一样有效,如果操作得当,是转子下骨折的有效替代治疗方法。
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引用次数: 0
Alteration of Salivary Calcium and Statherin Levels in Patients with Gingivitis and Periodontitis 牙龈炎和牙周炎患者唾液钙和钙素水平的改变
Pub Date : 2017-07-01 DOI: 10.9790/0853-1607011719
A. Primasari, Yumi Lindawati, Irma Ervina
‘Salivary proteins have an important influence in tooth enamel remineralize associated with calcium hydroxyapatite. Statherin is the most powerful protein that binds calcium hydroxyapatite in saliva than other calcium-binding protein. Infection in gingiva and periodontal caused alteration of statherin and calcium levels. Therefore, researchers wanted to determine and to compare salivary statherin and calcium levels in gingivitis and periodontitic mainly on the Indonesian as an initial data to explore the influence of statherin and calcium in patients with gingivitis and periodontitic. By spitting method, 54 samples of whole saliva taken from gingivitis and periodontitic patients ; aged 20-50 years, doesn’t have antibiotic treatment in 3 months, no smoking, no areca chewing, not pregnant, lactating or menstruating. Statherin level measurement using ELISA method and calcium level by spectrophotometry method. Results showed mean concentration of statherin for gingivitis is 1,79 ug / ml, while periodontitics is 2,73 ug / ml. Mean concentration for calcium in gingivitis saliva is 5,31 mmol/l, and periodontitic is 0,18 mmol/l. The Spearman’s correlation test showed 2 different results from 2 groups of samples. Gingivitis group showed there is no correlation between calsium and statherin in saliva (p>0,01), but periodontitic group showed there is significant correlation between calcium and statherin in saliva (p<0,05). The result showed that, although both are the result of salivary excretion (statherin and calcium), it turns out to different infection, showed different result. These results suggest there is a different mechanism in both infection.
唾液蛋白对牙釉质羟基磷灰石钙再矿化有重要影响。石蜡蛋白是结合唾液中羟基磷灰石钙的最强蛋白。牙龈及牙周感染可引起凝血素及钙水平的改变。因此,研究人员希望确定并比较牙龈炎和牙周病患者唾液中施他汀素和钙的水平,主要以印度尼西亚人为研究对象,作为初步数据,探讨施他汀素和钙对牙龈炎和牙周病患者的影响。采用吐痰法采集牙龈炎、牙周病患者全唾液54份;年龄20-50岁,3个月内没有抗生素治疗,不吸烟,不嚼槟榔,没有怀孕、哺乳期、月经。酶联免疫吸附法测定施他汀素水平,分光光度法测定钙水平。结果牙龈炎和牙周病患者唾液中施他汀素平均浓度分别为1.79 ug / ml和2.73 ug / ml,牙龈炎和牙周病患者唾液中钙的平均浓度分别为5.31 mmol/l和0.18 mmol/l。Spearman相关检验从两组样本中得出了两种不同的结果。牙龈炎组患者唾液中钙含量与statherin含量无相关性(p> 0.01),牙周病组患者唾液中钙含量与statherin含量有显著相关性(p< 0.05)。结果表明,虽然两者都是唾液排泄的结果(凝血素和钙),但结果表明,不同的感染,表现出不同的结果。这些结果表明,在这两种感染中存在不同的机制。
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引用次数: 1
Cognitive impairment in patients with epilepsy: A case control study at a tertiary level hospital in India 癫痫患者的认知障碍:印度一家三级医院的病例对照研究
Pub Date : 2017-07-01 DOI: 10.9790/0853-160702103106
Dr.Ravindra B. Narod, Dr.Rathod Rahul Narayanrao, Dr.Sayali V. Bhambar, Dr.Sapna Anjutagi, Dr.Smit U. Janrao, Dr.Pranav Deore
Introduction: Cognition is defined as the capacity of the brain to process information accurately leading to an adaptive behaviour. This study aims at understanding the decline in cognition in patients diagnosed with epilepsy in India using a standardized cognition scale. Methodology: We did a case control study in the Department of Psychiatry, Government Medical College, Miraj in which all patients with a diagnosis of epilepsy from October 2016 till February 2017 were included. Patients were tested for cognitive impairment using the PGI Memory scale (PGIMS). Controls were included from the population sample of non teaching staff of college. We noted age, gender, handedness, and education levels and clinical information. All cases and controls were tested for cognitive functioning using PGIMS. The data was analysed descriptively and then the cases and controls were compared using the unpaired Student’s t test, with p value less than 0.05 being statistically significant. Results:We enrolled 60 patients diagnosed with epilepsy and same number of healthy controls from the same insitution. Average age of the patients with epilepsy was 43.7±2.4 years and that of controls was 48.1±3.6 years. The difference between the cases and controls was found to be statistically highly significant in cognition tests like recent memory, remote memory, immediate recall and visual retention. On cognitive tests like attention and concentration, retention of dissimilar pairs, mental balance the difference between the groups was found to be statistically significant. Conclusions: Findings of our study demonstrates that patients with epilepsy shuould be routinely tested for cognitive decline.
导读:认知被定义为大脑准确处理信息并导致适应性行为的能力。本研究旨在了解认知能力下降的患者诊断癫痫在印度使用标准化的认知量表。方法:我们在Miraj政府医学院精神学系进行了一项病例对照研究,其中包括2016年10月至2017年2月期间诊断为癫痫的所有患者。使用PGI记忆量表(PGIMS)对患者进行认知障碍测试。对照从高校非教学人员的总体样本中选取。我们记录了年龄、性别、惯用手、教育水平和临床信息。使用PGIMS对所有病例和对照组进行认知功能测试。对数据进行描述性分析,然后用unpaired Student’s t检验比较病例和对照组,p值小于0.05为有统计学意义。结果:我们从同一机构招募了60名癫痫患者和相同数量的健康对照。癫痫患者平均年龄为43.7±2.4岁,对照组平均年龄为48.1±3.6岁。研究发现,在近期记忆、远程记忆、即时回忆和视觉保留等认知测试中,病例和对照组之间的差异在统计上非常显著。在认知测试中,比如注意力和注意力,对不同组合的记忆,心理平衡,两组之间的差异在统计上是显著的。结论:我们的研究结果表明癫痫患者应该进行常规的认知能力下降测试。
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引用次数: 0
Prevalence of Dengue Virus Infection Among Febrile Outpatients Attending University of Maiduguri Teaching Hospital in Borno State, Nigeria 尼日利亚博尔诺州迈杜古里大学教学医院发热门诊患者登革热病毒感染流行情况
Pub Date : 2017-07-01 DOI: 10.9790/0853-160603155159
T. M. Hamisu, A. Yuguda, M. Abubakar, Y. Shettima, M. Maina, M. Y. Zanna, S. S. Baba, A. Andrew, i.C. Terhemen
Dengue fever is a zoonotic arthropod-borne viral disease caused by Dengue fever virus (DENV) of the Genus Flavivirus and the FamilyFlaviviridaethat is endemic in Africa and beyond. The illness could be fatal especially among children and depleted patients.This study was designed to diagnose recentDengue virus infectionsamong febrile patients attending University of Maiduguri Teaching Hospital using ELISA kits for the detection of DENV IgM antibodies and NS1 antigens. Ninety one (91) venous blood samples were randomly collected from patients attending Maiduguri Teaching Hospital for malaria test between January and May, 2016. The samples were analysed using Enzyme Linked Immunosorbent Assays for dengue virus IgM antibodies (manufactured by Inverness Innovations Australia Pty Ltd ) and for Dengue virus NS1antigens (manufactured by Bio-Rad, France). The results showed a prevalence rate of 37.4% for DENV IgM antibodies and 9.9% for DENV NS1 antigens, with 3.3% of the subjects testingpositive for both IgM and NS1 antigen. Females were observed to have higher IgM prevalence rate of 41% and males showed higher NS1 antigen prevalence rate of 11.1%. The highest prevalence rate of 76.9% was recorded for IgM in the age bracket of 1-14 years. Samples from urban areas have the highest IgM antibodyprevalence rate of 41.4%, however, rural dwellers have the highest NS1 antigen prevalence rate of 11.3%. The presenting complaint with the highest IgM prevalence rate of 50% was headache + fever + nausea, while headache only had the highest NS1 antigen of 22.2%. The highest prevalence rate of 47.4% for IgM and 50% for NS1 antigen were recorded in March and May, 2016 respectively. This study therefore showed a high prevalence of IgM to Dengue fever virus indicating its circulation among febrile patients attending University of Maiduguri Teaching Hospital. Due to the probable misdiagnosis and subsequent treatment of dengue fever with other diseases such as malaria, dengue fever is shown to be prevalent in the study area. It is therefore recommended that febrile patients attending Maiduguri Teaching Hospital should be tested for dengue fever virus.
登革热是由黄病毒属和黄病毒科登革热病毒(DENV)引起的一种人畜共患节肢动物传播的病毒性疾病,在非洲及其他地区流行。这种疾病可能是致命的,特别是在儿童和虚弱的病人中。本研究旨在利用ELISA试剂盒检测DENV IgM抗体和NS1抗原,诊断迈杜古里大学教学医院发热患者近期登革热病毒感染。2016年1月至5月在迈杜古里教学医院随机抽取91份静脉血进行疟疾检测。使用酶联免疫吸附法对样本进行分析,检测登革病毒IgM抗体(由Inverness Innovations Australia Pty Ltd生产)和登革病毒ns1抗原(由Bio-Rad,法国生产)。结果显示,登革热病毒IgM抗体阳性率为37.4%,NS1抗原阳性率为9.9%,其中IgM和NS1抗原均阳性的比例为3.3%。女性IgM患病率为41%,男性NS1抗原患病率为11.1%。1 ~ 14岁IgM患病率最高,为76.9%。城市地区IgM抗体患病率最高,为41.4%,而农村地区NS1抗原患病率最高,为11.3%。IgM患病率最高的主诉为头痛+发热+恶心(50%),而头痛的NS1抗原最高(22.2%)。2016年3月和5月IgM和NS1抗原感染率最高,分别为47.4%和50%。因此,这项研究表明登革热病毒IgM的高流行率表明其在迈杜古里大学教学医院的发热患者中传播。由于登革热与疟疾等其他疾病的误诊和后续治疗可能存在,因此登革热在研究地区普遍存在。因此,建议在迈杜古里教学医院就诊的发热病人应接受登革热病毒检测。
{"title":"Prevalence of Dengue Virus Infection Among Febrile Outpatients Attending University of Maiduguri Teaching Hospital in Borno State, Nigeria","authors":"T. M. Hamisu, A. Yuguda, M. Abubakar, Y. Shettima, M. Maina, M. Y. Zanna, S. S. Baba, A. Andrew, i.C. Terhemen","doi":"10.9790/0853-160603155159","DOIUrl":"https://doi.org/10.9790/0853-160603155159","url":null,"abstract":"Dengue fever is a zoonotic arthropod-borne viral disease caused by Dengue fever virus (DENV) of the Genus Flavivirus and the FamilyFlaviviridaethat is endemic in Africa and beyond. The illness could be fatal especially among children and depleted patients.This study was designed to diagnose recentDengue virus infectionsamong febrile patients attending University of Maiduguri Teaching Hospital using ELISA kits for the detection of DENV IgM antibodies and NS1 antigens. Ninety one (91) venous blood samples were randomly collected from patients attending Maiduguri Teaching Hospital for malaria test between January and May, 2016. The samples were analysed using Enzyme Linked Immunosorbent Assays for dengue virus IgM antibodies (manufactured by Inverness Innovations Australia Pty Ltd ) and for Dengue virus NS1antigens (manufactured by Bio-Rad, France). The results showed a prevalence rate of 37.4% for DENV IgM antibodies and 9.9% for DENV NS1 antigens, with 3.3% of the subjects testingpositive for both IgM and NS1 antigen. Females were observed to have higher IgM prevalence rate of 41% and males showed higher NS1 antigen prevalence rate of 11.1%. The highest prevalence rate of 76.9% was recorded for IgM in the age bracket of 1-14 years. Samples from urban areas have the highest IgM antibodyprevalence rate of 41.4%, however, rural dwellers have the highest NS1 antigen prevalence rate of 11.3%. The presenting complaint with the highest IgM prevalence rate of 50% was headache + fever + nausea, while headache only had the highest NS1 antigen of 22.2%. The highest prevalence rate of 47.4% for IgM and 50% for NS1 antigen were recorded in March and May, 2016 respectively. This study therefore showed a high prevalence of IgM to Dengue fever virus indicating its circulation among febrile patients attending University of Maiduguri Teaching Hospital. Due to the probable misdiagnosis and subsequent treatment of dengue fever with other diseases such as malaria, dengue fever is shown to be prevalent in the study area. It is therefore recommended that febrile patients attending Maiduguri Teaching Hospital should be tested for dengue fever virus.","PeriodicalId":14489,"journal":{"name":"IOSR Journal of Dental and Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87755443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Case Report: Mandibular Second Premolar, A Morphological Ingruity 病例报告:下颌第二前磨牙,形态不完整
Pub Date : 2017-07-01 DOI: 10.9790/0853-160603118120
Mridusmita Mukherjee, A. Bhattacharyya
The root canal is a complex system of finely tuned and synchronized small tributaries present along the body of tooth dentine. Therefore, knowledge of pulp anatomy is essential for endodontic treatment success, as lack of sound knowledge of the pulp anatomy can contribute to treatment failure. With the advancement of technological aids and numerous research have laid the foundation of multi rooted teeth or canals as the rule rather than exception. As such, bifurcating canals, multiple foramina, fins, deltas, loops, cul-de-sacs, C-shaped canals and accessory canals are commonly encountered in most teeth. So, accurate diagnosis followed by location, cleaning and shaping and finally obturation of such variations of canals is important as it determines the prospect of success of endodontic therapy.
根管是一个复杂的系统,由沿着牙本质的小支流组成。因此,牙髓解剖知识对于根管治疗的成功至关重要,因为缺乏牙髓解剖知识会导致治疗失败。随着技术的进步和大量的研究已经奠定了多根牙或多根根管的基础,而不是例外。因此,分叉根管、多孔根管、鳍状根管、三角根管、环状根管、死角根管、c形根管和副根管在大多数牙齿中都很常见。因此,准确的诊断,定位,清洁,整形,最后封闭这些管的变化是非常重要的,因为它决定了根管治疗成功的前景。
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引用次数: 0
Bone Marrow Aspiration Evaluation in Clinical Management of Anemia Among Low Socioeconomic Group In A Tertiary Care Hospital. 某三级医院低社会经济人群贫血临床管理中的骨髓抽吸评价
Pub Date : 2017-07-01 DOI: 10.9790/0853-1607028997
J. JohnsyMerla, J. SureshDurai, K. Shantaraman
Bone marrow aspiration (BMA) is a relatively safe invasive procedure by which representative sample of bone marrow is obtained through a needle aspiration for diagnostic evaluations. A total of 331 cases of anemia were profiled during the study period. The age range of patients were from 10 to 81 years. The majority of the subjects was in the adolescent age group of 10 – 19 years(20.54%). A complete blood count and peripheral smear examination in these cases revealed 125(37.76%) microcytic hypochromic anemia followed by 116(35.05%) Dimorphic anemia,23(6.95%)Pancytopenia, 23(6.95%)leukemia,31 cases (9.37%) macrocytic anemia,2 haemolytic anemia and 11(3.32%) were normocytic. These cases were further evaluated with bone marrow examination bone-marrow aspiration revealed 88 (26.59%) erythroid hyperplasia with micronormoblastic and macronormoblastic maturation(Combined deficiency),56 ( 16.92%) micronormoblastic maturation, 38 (11.48%) megaloblastic maturation, 23 ( 6.95%) Leukemia, Plasma cell myeloma 7(2.11%), lymphoma 6 (1.81%), hypoplastic marrow 5 (1.51%), haemophagocytic Lymphohistiocytosis 4 (1.21%),3 (0.91%) myelodysplastic syndrome, 2 (0.60%)cases of idiopathic thrombocytopenic purpura.In 22 (6.65%) cases the marrow was reactive. The age, sex, peripheral smear study, bone marrow aspiration study and diagnosis were collated and statistically analyzed. A definite diagnosis of plasma cell myeloma,lymphoma and myelodysplastic syndrome was possible only with bone marrow evaluation. In our study,in 77 % of cases a definite diagnosis of cause of anemia was arrived after bone marrow evaluation. 50% of cases were diagnosed with megaloblastic anemia indicating an underlying B12 and folate deficiency.
骨髓穿刺(BMA)是一种相对安全的侵入性手术,通过针吸获得有代表性的骨髓样本进行诊断评估。在研究期间,共记录了331例贫血病例。患者年龄10 ~ 81岁。调查对象以10 ~ 19岁青少年为主(20.54%)。全血细胞计数及外周血涂片检查显示:小细胞性低色素贫血125例(37.76%),二形性贫血116例(35.05%),全血细胞减少症23例(6.95%),白血病23例(6.95%),巨细胞性贫血31例(9.37%),溶血性贫血2例(3.32%),正常细胞性贫血11例(3.32%)。进一步行骨髓检查,骨髓穿刺示红系增生伴微母细胞和巨母细胞成熟88例(26.59%),微母细胞成熟56例(16.92%),巨母细胞成熟38例(11.48%),白血病23例(6.95%),浆细胞骨髓瘤7例(2.11%),淋巴瘤6例(1.81%),骨髓发育不良5例(1.51%),噬血细胞淋巴组织细胞增多症4例(1.21%),骨髓增生异常综合征3例(0.91%),骨髓增生异常综合征3例(0.91%)。特发性血小板减少性紫癜2例(0.60%)。22例(6.65%)患者骨髓有反应。对年龄、性别、外周血涂片检查、骨髓穿刺检查及诊断进行统计分析。只有骨髓评估才能明确诊断浆细胞骨髓瘤、淋巴瘤和骨髓增生异常综合征。在我们的研究中,有77%的病例在骨髓评估后明确诊断出贫血的原因。50%的病例被诊断为巨幼细胞性贫血,表明潜在的B12和叶酸缺乏。
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引用次数: 1
Evaluation And Correlation of Insulin Resistance And Lipid Profile In Normal Pregnancy And Preeclampsia 正常妊娠和子痫前期胰岛素抵抗和血脂的评价及相关性
Pub Date : 2017-07-01 DOI: 10.9790/0853-160603121125
Partiksha Partiksha, R. Bhatia, C. Vij, G. Bedi
Background: Preeclampsia syndrome is clinical spectrum of worsening disease with attenuated manifestations to cataclysmic deterioration, Life threatening for both mother and fetus. It affects 5-10% of all pregnancies & forms deadly triad with haemorrhage and infection being a direct cause of maternal mortality. Preeclampsia is associated with hyper insulinemia, increased insulin resistance which induces hypertriglyceridemia, endothelial dysfunction. It may lead to preeclampsia in genetically predisposed pregnant women. Association of high serum lipids with gestational protinuric hyerptension is highly suggestive of role for lipid profile analysis as diagnostic tool for preeclampisa. Aims & Objective: To evaluate and correlate fasting plasma insulin levels, insulin resistance and lipid profile in preeclampsia and normal pregnancy in ≥ 20 wks gestation. Material & methods: This is prospective observational study undertaken for one year on 40 pregnant women with preeclampsia and 25 normal pregnant women in tertiary care hospital in North India. Fasting plasma insulin levels, insulin resistance and lipid profile were evaluated in all 65 pregnant women in study and control group. Results: Mean age 26.±4.48 years, 25.0±2.79 years, mean period of gestation 32.38±2.53 wks, 29.48 ± 2.50 weeks in study & control group respectively were comparable. 52% patients in both the groups were primigravida. Mean fasting plasma insulin levels in study group i.e. 53.3 μIU/ml was significantly higher than, 16.35 μIU/ml in control group. Insulin resistance (HOMA IR index) in preeclampsia was 10.33, significantly high compared to 3.04 in normotensive pregnant women. Lipid profileserum cholesterol, triglycerides, HDL, LDL, VLDL were significantly raised in preeclampsia compared to control group. Conclusion: Highly significant increase in fasting plasma insulin levels, insulin resistance and lipid profile compared to normotensive pregnant females is a diagnostic tool for early diagnosis and management of preeclampsia step towards reducing maternal mortality and adverse fetal outcome.
背景:子痫前期综合征是一种由症状逐渐加重到剧烈恶化的疾病,对母胎均有生命威胁。它影响所有怀孕的5-10%,形成致命的三位一体,出血和感染是孕产妇死亡的直接原因。子痫前期与高胰岛素血症、胰岛素抵抗增加引起高甘油三酯血症和内皮功能障碍有关。它可能导致遗传易感孕妇先兆子痫。高血脂与妊娠期原尿酸高血压的关联,高度提示血脂分析作为子痫前期诊断工具的作用。目的:探讨妊娠≥20周子痫前期和正常妊娠空腹血浆胰岛素水平、胰岛素抵抗和血脂水平的相关性。材料与方法:这是一项为期一年的前瞻性观察研究,在印度北部三级医院对40名先兆子痫孕妇和25名正常孕妇进行研究。对研究组和对照组的65名孕妇进行空腹血浆胰岛素水平、胰岛素抵抗和血脂分析。结果:两组患者平均年龄分别为(26±4.48)岁、(25.0±2.79)岁,平均妊娠期分别为(32.38±2.53)周、(29.48±2.50)周,具有可比性。两组患者中52%为初迁性。研究组空腹血浆胰岛素水平为53.3 μIU/ml,显著高于对照组的16.35 μIU/ml。子痫前期患者的胰岛素抵抗(HOMA IR指数)为10.33,显著高于血压正常孕妇的3.04。与对照组相比,子痫前期血清胆固醇、甘油三酯、HDL、LDL、VLDL明显升高。结论:与正常妊娠女性相比,空腹血浆胰岛素水平、胰岛素抵抗和血脂水平显著升高是早期诊断和管理子痫前期的诊断工具,有助于降低孕产妇死亡率和不良胎儿结局。
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引用次数: 1
A Study on Prevalence of Left Ventricular Dysfunction and Its Correlation with Estimated Glomerular Filtration Rate (eGFR) in CKD patients CKD患者左心室功能障碍患病率及其与肾小球滤过率(eGFR)相关性的研究
Pub Date : 2017-07-01 DOI: 10.9790/0853-160603108112
C. Dharmaraj, Tina Ann Antony, G. Prasannan
BACKGROUND AND OBJECTIVE: In Chronic Kidney Disease there is a higher incidence cardiovascular events. Most of the patients with CKD succumb to cardiovascular disease even before they reach the end stage of renal disease. Hence all efforts should be given in earlier stages of CKD to prevent the development of cardiovascular complications. LV diastolic dysfunction is found to antedate LVH and systolic dysfunction. It is not just associated with hemodynamic factors like anaemia and hypertension, but also with uraemia related non hemodynamic factors like secondary hyperparathyroidism, altered mineral metabolism, cardiotrophysin etc. ECHO provides a simple non-invasive method to assess the left ventricular structure and function, which helps us in identifying those prone for cardiovascular complications at an earlier stage of CKD. This study was done to find out the prevalence of LV dysfunction and its correlation with eGFR in CKD patients. METHODS: 50 hypertensive CKD patients and 50 normotensive CKD patients admitted to Government Rajaji Hospital between May 2013 to August 2014 were evaluated for the presence of LV dysfunction and LVH and the results were compared with that of 50 age and sex matched individuals. Patients with acute kidney injury, prior coronary artery disease, valvular heart disease, cardiomyopathy, diabetic individuals and CKD patients on renal replacement therapy or transplant patients were excluded from the study. The CKD patients were divided into various stages of CKD based on their eGFR (calculated according to MDRD formula) and they were evaluated by ECHO. Those with an ejection fraction 2 was grade III diastolic dysfunction. This was compared with the ECHO findings of the controls. The collected data was analysed using various statistical methods. RESULTS: 74% of CKD patients had LV diastolic dysfunction (p <0.0001). Diastolic dysfunction was found to occur in 84% of the hypertensive CKD and in 64% of the normotensive CKD (p=0.02). Comparing the CKD normotensives with the control group, 64% among the normotensive CKD had diastolic dysfunction whereas only16% of controls had diastolic dysfunction (p<0.05). There is a negative correlation between the eGFR and diastolic dysfunction. So as the eGFR falls, the diastolic dysfunction increases. INTERPRETATION AND CONCLUSION: Even in the absence of hypertension, LV diastolic dysfunction can occur in CKD. This emphasizes the need for correction of not just hemodynamic factors but also the uraemia related factors.
背景与目的:慢性肾脏病患者心血管事件发生率较高。大多数CKD患者甚至在达到肾脏疾病的终末期之前就死于心血管疾病。因此,在CKD的早期阶段应尽一切努力预防心血管并发症的发展。发现左室舒张功能障碍早于左室和收缩功能障碍。它不仅与贫血、高血压等血流动力学因素有关,还与尿毒症相关的非血流动力学因素有关,如继发性甲状旁腺功能亢进、矿物质代谢改变、心肌素等。ECHO提供了一种简单的非侵入性方法来评估左心室结构和功能,有助于我们识别CKD早期易发生心血管并发症的患者。本研究旨在了解CKD患者左室功能障碍的发生率及其与eGFR的相关性。方法:对2013年5月至2014年8月在Rajaji政府医院住院的50例高血压CKD患者和50例正常CKD患者进行左室功能障碍和LVH的评估,并将结果与50例年龄和性别匹配的个体进行比较。急性肾损伤患者、既往冠状动脉疾病患者、瓣膜性心脏病患者、心肌病患者、糖尿病患者以及接受肾脏替代治疗的CKD患者或移植患者均被排除在研究之外。根据eGFR(根据MDRD公式计算)将CKD患者分为不同的CKD阶段,并采用ECHO进行评价。射血分数为2的患者为III级舒张功能障碍。这与对照组的ECHO结果进行了比较。用各种统计方法对收集到的数据进行分析。结果:74%的CKD患者存在左室舒张功能不全(p <0.0001)。发现84%的高血压CKD和64%的正常CKD存在舒张功能障碍(p=0.02)。与对照组比较,正常CKD患者中有64%存在舒张功能不全,而对照组只有16%存在舒张功能不全(p<0.05)。eGFR与舒张功能障碍呈负相关。随着eGFR下降,舒张功能障碍增加。解释和结论:即使没有高血压,CKD也可能发生左室舒张功能障碍。这强调了不仅需要纠正血流动力学因素,而且需要纠正尿毒症相关因素。
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引用次数: 0
Double-Arm Clasp with Anterior Placed Occlusal Rest Retained Mandibular Distal Extension Removable Partial Denture - Stress Analysis and Alveolar Bone Height Changes of Abutments. 下颌远端延伸可摘局部义齿-基牙应力分析及牙槽骨高度变化。
Pub Date : 2017-07-01 DOI: 10.9790/0853-160702114119
H. Wageh, A. Mm, Salah A. Hegazy, Mostafa Az
Aim: study the effect of double-arm clasps as retainer units for bilateral mandibular distal extension removable partial denture regard: Study of stress analysis applied on the abutments (in-vitro) and abutment alveolar bone height changes (in-vivo).The retainer clasps includes: Reverse circlet clasp and Modified Half-and-Half clasp assembly. Materials and methods: In-vitro study: Model RPD distal extension with three frameworks of different retainer units for stress analysis. In-vivo study: In a randomized controlled clinical trial, fifteen patients with completely edentulous maxilla and remaining mandibular eight anterior teeth including 1st premolar. They were randomly divided to three groups. All patients received maxillary complete denture. Group I: where distal extension RPD designed with Reverse circlet clasp. Group II: where distal extension RPD designed with modified halfandhalf clasp assembly without distal occlusal rest and retentive clasp arm arising from anterior occlusal rest. Group III: where distal extension RPD designed with modified Half and Half clasp assembly without distal occlusal rest and modified retentive clasp arm arising from proximal guiding plate. The abutment tooth was evaluated radio graphically by digital periapical radiographs after insertion, after 6 months and after 12months after denture insertion. Results: Group I (Reverse circlet clasp) significant increase in bone resorption of abutment compared to those in Group II and Group III (modified half-and-half clasp assembly). From stress point of view, in bilateral loading group I applied more stress to abutment compared to group II and III. Conclusion: Group II &III modified half-and-half clasp assemblies (stress releasing clasp assembly) superior to reverse circlet clasp regard to abutment alveolar bone resorption of distal extension cases. Reverse circlet clasp (Group I) not purely stress releasing by disengagement regarding double arm clasp utilize for this purpose. From stress transmitted point of view (bilateral loading), modified half-and-half clasp assembly (group II) exhibit less stresses transmitted to the abutment than exhibit in group III as a result obtained in this study (in-vitro) that minimize abutment alveolar bone resorption compared to group I to group II& III. This research recommends the application of a new stress releasing clasp designs for distal extension RPD (modified halfand-half clasp assemblies as in group II & III). These assemblies should be added to retainer units of stress releasing action by disengagement.
目的:研究双臂卡环作为双侧下颌远端可摘局部义齿固位单元的作用:研究应力分析对基牙(离体)和基牙牙槽骨高度变化(体内)的影响。固定卡扣包括:反环卡扣和改进的半-半卡扣组件。材料与方法:体外研究:采用三种框架不同固位单元的RPD远端延伸模型进行应力分析。活体研究:在一项随机对照临床试验中,15例上颌完全无牙和下颌剩余8颗前牙包括第一前磨牙。他们被随机分为三组。所有患者均采用上颌全口义齿。第一组:远端延伸RPD设计反向环形卡环。II组:远端延伸RPD设计为改良的半卡环总成,不带远端咬合托,前咬合托产生固位卡环臂。III组:远端延伸RPD设计为改良的半卡环和半卡环总成,不带远端咬合支架,改良的固定卡环臂由近端引导板产生。在义齿植入后、植入后6个月和植入后12个月,通过数字根尖周x线片对基牙进行放射学评价。结果:I组(反环卡环)与II组和III组(改良半-半卡环组合)相比,基台骨吸收明显增加。从应力角度看,双侧加载组I对基台施加的应力大于II组和III组。结论:改良半-半卡环组(应力释放卡环组)对远端伸展病例基牙牙槽骨吸收效果优于反环卡环组。反向环扣(组I)不纯粹的压力释放,对于用于此目的的双臂扣。从传递应力的角度来看(双侧载荷),改良的半-半卡环装配(II组)传递到基牙的应力比III组少,这是本研究(体外)获得的结果,与I组到II组和III组相比,可以最大限度地减少基牙牙槽骨吸收。本研究建议应用一种新的应力释放卡环设计用于远端延伸RPD(改进的半-半卡环组件,如第II组和第III组)。这些组件应通过分离添加到应力释放作用的固定单元中。
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引用次数: 0
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IOSR Journal of Dental and Medical Sciences
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