Open Access Case Study

Steatocystoma Multiplex Limited to the Vulva: Report of a Very Rare Case Successfully Treated by a Simple Surgical Method

Selda Pelin Kartal, Engin Sezer, Murat Alper, Muzeyyen Gonul

Journal of Advances in Medicine and Medical Research, Page 1-5
DOI: 10.9734/BJMMR/2016/27081

Aim: Steatocystoma multiplex (SM) is a rare malformation characterized by multiple cutaneous cystic lesions containing oily substance. SM has autosomal dominant mode of inheritance, though there are a significant number of sporadic cases reported as well. Characteristically, the lesions manifest around the time of puberty and are found on the sternal areas, face, trunk and scrotum. SM limited to the vulva is a very rare condition as there are only a five cases in the literature.

Case: A 32-year-old woman presented with a 1 year-history of nodules, gradually increasing in size and number, on the labia majora. Similar lesions were not present on other parts of her body and family members. On physical examination, yellowish papules and nodules ranging in size from 2-15mm without punctum were present on the labia majora. Biopsy performed at the time revealed histological changes with steatocystoma multiplex. After a mini incision, evacuation of the cyst followed by the removal of the cyst wall was performed without complication. The lesions healed rapidly without scarring. The patient was followed by yearly controls. Recurrence was not observed until the fourth year of surgery. Smaller lesions were observed on previously untreated areas of vulva which were removed again successfully.

Discussion: SM treatment is difficult. In addition to medical treatments including antibiotic and anti-inflammatory drugs and isotretinoin, there are different surgical treatments including total excision and grafting, cryotherapy and CO2 laser with limited success.

Conclusion: This is a very rare case of SM limited to the vulva, simply and successfully treated by a simple surgical method, emphasizing the importance of cyst wall removal to achieve long time remission.

Open Access Case Study

Peripheral Cemento-ossifying Fibroma -treatment and Follow Up of a Recurrent Case

Sonu Acharya, Pradip Kumar Mandal, Sheetal Acharya

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/26380

Peripheral cemento-ossifying fibroma is a non neoplastic growth of soft tissue which often arises from the interdental papilla and is mostly seen in teenagers and young adults. Here we discuss a case of peripheral cemento-ossifying fibroma in a 15 years old male which had been surgically excised previously and recurred after a period of 8 months in the same region. Keeping in mind the recurrence rate, meticulous surgical excision and aggressive curettage of the nearby tissues are to be done to prevent further recurrence.

Open Access Original Research Article

Profile of Juvenile Idiopathic Arthritis Observed in Abidjan (Cote d’Ivoire): A Report about 17 Cases

Mohamed Diomandé, Abidou Kawélé Coulibaly, Ehaulier Soh Christian Louis Kouakou, Joe Clovis Yao, Cyprien Kouakou, Mariam Gbané-Koné, Baly Ouattara, Kouassi Jean Mermoze Djaha, Edmond Eti, Jean Claude Daboiko, Marcel N’zué Kouakou

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/27043

Background: Juvenile idiopathic arthritis is the most common rheumatic disease in children. Compared to Western countries, very few studies have been devoted to this disease in black sub-Saharan Africa. The aim is to describe the epidemiological, clinical, paraclinical and therapeutic features of juvenile idiopathic arthritis observed in Abidjan and identify the clinical forms.

Methodology: This descriptive retrospective study covered 17 children (11 girls and 6 boys, age range: 3-15 years) suffering from juvenile idiopathic arthritis which met the Durban criteria of 1997 revised in Edmonton in 2001. The children have been selected in the rheumatology department of University Hospital Center of Cocody in Abidjan from January 2005 to December 2013. We were interested to sociodemographic, clinical, biological, radiological and therapeutic parameters.

Results: The frequency of juvenile idiopathic arthritis was 0.03% that was 17 children among the 4608 rheumatic diseases identified during the study period. The number of patients was dominated by females (64.7%) and the average age at the time of diagnosis was 11 years. The average delay at the time of diagnosis was 15 months. The main complaints of patients were fever, joint involvement and impaired general condition observed each in 12 cases. It was noted the presence of radiographic erosions in 4 cases and 1 case of coxitis on Computer tomography scan. The clinical forms identified were systemic form (12 cases), oligoarticular form (1 case), polyarticular form with positive rheumatoid factors (3 cases), enthesitis-related arthritis (1 case). The vast majority of our patients (15 of 17) was treated with the combination therapy corticosteroid and methotrexate.

Conclusion: Juvenile idiopathic arthritis appears very uncommon and affects female children. It is expressed by febrile arthritis with an impaired general condition and is dominated by the systemic form.

Open Access Original Research Article

Haematological and Kidney Function Indices of Piliostigma thonningii Leaf Extract Administration Following Pefloxacin Induced Toxicity in Wistar Rats

Kayode Dasofunjo, Atamgba A. Asuk, Obem O. Okwari, Mary Oli

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/26642

Aims: The study investigated haematological and kidney function indices of Wistar rats administered Piliostigma thonningii ethanol leaf extract after being induced with therapeutic doses of pefloxacin (400 mg/5 mL).

Place and Duration of Study: Department of Medical Biochemistry, Cross River University of Technology, Okuku Campus, between August 2013 and June 2014.

Methodology: Twenty four male Wistar rats weighing between 185-200 g were assigned into four groups. Administration was orally, with groups A (control), B and C receiving 0.5 mL each of distilled water, P. thonningii extract and pefloxacin respectively, while group D was co-administered P. thonningii extract and pefloxacin (1:1). The rats were sacrificed after 21 days and blood collected for study.

Results: P. thonningii extract co-administration with pefloxacin produced a significant (P<0.05) increase in hematocrit (HCT), lymphocytes and neutrophils and a significant (P<0.05) decrease in platelets count compared with the rest of the groups. The effects of pefloxacin co-administration with P. thonningii extract on serum electrolyte and kidney function indices were not clear-cut, however creatinine levels were normal.

Conclusion: Synergistic and antagonistic effects of pefloxacin co-administration with P. thonningii leaf extract were demonstrated. These effects when properly harnessed could be useful in the management of anaemic conditions, immune responses as well as bone demineralization relating to drug toxicity.

Open Access Original Research Article

Ex vivo Analysis of Three Electronic Apex Locators Accuracy with Different Settings

Antonio Batista, Gilson Blitzkow Sydney, Marili Doro Andrade Deonizio, Thais Cristina Pereira, Carolina Carvalho de Oliveira Santos, Bruno Cavalini Cavenago

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/26477

Aims: The correct determination of a root canal length is a fundamental step for an adequate chemical-mechanical preparation and consequently, for a successful endodontic treatment. Electronic apex locators (EAL) were developed to provide fast and reliable working lengths. The aim of the present study was to analyze the accuracy of the Root ZX II, RomiApex A-15, and SmarPex EAL’s to determine the location of apical constriction, with and without the instructions recommended by the manufacturers.

Methodology: Fifteen mandibular premolars were randomly selected and root canals were accessed. The real canal length was determined by introducing a #15 K-file until the tip was visualized in the apical foramen, using 40x magnification of an operative microscope. In the sequence, the teeth were inserted in plastic flasks containing floral foam soaked in 0.9% saline solution. The root canals were filled with 1% sodium hypochlorite and the electronic measures were obtained with the selected devices until the “0.0” or the last green bar mark, as showed in devices display, and as per the manufacturers settings recommendation. The data were submitted to statistical analysis with the Friedman and Wilcoxon tests with a 0.05% significance level (p < 0.05).

Results: All devices were similar (p > 0.05) and showed precise and acceptable measurements at both times. Without manufacturers setting recommendation, the Root ZX II was the EAL that presented the greater percentage of coincidences with the real teeth length measures (73.33%), followed by the RomiApex A-15 (66.66%) and the SmarPex (40%). After performing the recommended settings the Root ZX II and the SmarPex presented 86.66% of coincidence with the real length, however, only the SmarPex device enhanced the mean precision with the real length (p < 0.05).

Conclusion: Considering a clinically acceptable average error of ±0.5 mm, all devices were effective in determining the measurement until the apical constriction. Although, there were no statistical significant difference with and without manufacturers instruction, for Root ZX II, the performance was better when manufacturer instructions were followed.

Open Access Original Research Article

Prevalence and Pattern of Impacted Teeth in the North-East China

Nyimi Bushabu Fidele, Sekele Isouradi Bourley, Em Kalala Kazadi, Duan Feng, C. Mfutu Mana, P. Bobe Alifi, J. Bolenge Ileboso, P. Muyembi Muinaminayi, Guan Jian, A. Mantshumba Milolo

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/27134

Aims: To investigate the prevalence and pattern of impacted teeth in the sample of North-East China.   

Study Design: Descriptive and Retrospective study.

Place and Duration of Study: School of Stomatology, Department of oral and maxillofacial surgery, Second Affiliated Dental Hospital of Jiamusi University Between Jun 2013 to October 2015.

Methodology: Orthopantomogram radiographs and clinical dental records are used to determine the impacted teeth in Five thousand seven hundred and eighty four randomly selected patients. All of 5784 patients were examined (3754 males, 2030 females), with an age range of 7-76 years and a mean age of 23±4 years. The minimum age for inclusion was 7 years. The data was entered into the computer and analyzed using the Statistical Package for Social Sciences (version 20. Inc. Chicago, USA). The Pearson’s Chi‑square was used to determine the differences in the distribution of impacted teeth between genders. The significant level was tested at the 5%.

Results: Out of 5784 patients, a total of 1342 (23.2%) presented an impacted tooth, 701 (52.2%) were male and 641(47.8%) were female. Among them, 1485 were the number of impacted teeth. The prevalence of impacted teeth was 23.2%; third molars were the most common (11.70%; n=677), followed by canines (5.55%; n=321), incisor and premolars (2.92%; n=169 and 2.82%; n=163). The impacted teeth were mostly seen in the age group between 17-26 years old (43.8%; n=774).  No significant relationship between impacted teeth among the gender was found (p=0.22).

Conclusion: The prevalence of impacted teeth was 23.2% in this research and the patients aged between 17 to 26 years were most affected. The minimum age of 7 years must be an inclusion criteria study for to assess the real prevalence of incisor impaction.

Open Access Original Research Article

Escitalopram Usage Pattern in India: A Knowledge, Attitude and Practice Survey among Indian Psychiatrists

Deepak Mansharamani, Sunil Awana, Gorla Jagannath, Juzer Ali, Neel Jayesh Shah, Onkar C. Swami

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2016/26101

Introduction: Escitalopram is a popular and commonly prescribed anti-depressant in routine clinical practice in India. The objective of this survey was to explore knowledge, attitude and practice (KAP) of escitalopram usage pattern in routine clinical practice amongst Indian psychiatrists.

Methodology: Total 280 psychiatrists across India were surveyed and KAP were evaluated. Twelve questions which explored indications, dosages, duration, efficacy, tolerability and comparison were asked and results were expressed as percentages.

Results: Major depressive disorder and anxiety disorder were found to be the common indications along with Post-Traumatic Stress Disorder (PTSD) and Obsessive Compulsive Disorder (OCD). Escitalopram was reported to be used mostly at 10 mg dosage for 6-12 months. Escitalopram was found to be preferred in the elderly and in patients with cardiac diseases. Weight gain, gastrointestinal intolerance and sexual disturbances were commonly reported with the latter often leading to discontinuation. However, the tolerability compared to other Selective Serotonin Receptor Inhibitors (SSRIs) was reported to be good to excellent. Some of the adverse effects reported were weight gain, sexual disturbances and gastrointestinal intolerance.

Conclusion: The present KAP survey highlights that escitalopram’s effectiveness and tolerability are valued by many Indian psychiatrists to be good to excellent and account for its robust clinical utility.

Open Access Original Research Article

Occurrences of Idiopathic Congenital Talipes Equinovarus at the Komfo Anokye Teaching Hospital

Thomas Abebrese

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/27304

Aim: To investigate the occurrences and seasonal distribution of idiopathic clubfoot at the Komfo Anokye Teaching Hospital.

Study Design: A five – year – retrospective cross – sectional study was conducted from January 1, 2010 to December 31, 2014.

Place and Duration of the Study:  The study was conducted at the Department of Physiotherapy of the Komfo Anokye Teaching Hospital, Kumasi – Ghana, between November 2015 and March 2016.

Methodology: Clinical folders of all congenital clubfoot cases over the stipulated period were reviewed, out of which 420 fell under idiopathic category of the deformity. Data on the demographic characteristics, coupled with the occurrences, in time series, of idiopathic clubfoot, were retrieved, entered into SPSS version 20, and analyzed with inferential and descriptive statistical tools.

Results: Four hundred and twenty (420) cases of idiopathic clubfoot were reviewed. Males recorded higher prevalence 217 (51.7%) than females, with majority of the cases (57.0%) being bilateral. Chi square testing revealed that there was no significant association between gender and number of feet affected (P = .95), and no significant associations between the climatic season and the following; dominant gender category affected (P = .43) and number of feet affected (P = .31).  Analysis of the trend line produced (r = - 0.04), confirming a negative trend of the deformity since 2010, but the slope parameter is not significant at 5% significance level (P = 0.09).

Conclusion: According to the findings of the study, external climatic conditions may have very little or no influence on the occurrences and distribution of idiopathic clubfoot. Thus, the aetiology may be skewed largely to inherent pathophysiologic and or genetic events during foetal development.

Open Access Original Research Article

Technological Tools for Observational Evaluation - the Experience with the Software for Functional Evaluation Scale for Duchenne Muscular Dystrophy – A Pilot Study Software for Observational Evaluation

Priscila Santos Albuquerque, Fatima Aparecida Caromano, Mariana Callil Voos, Francis Meire Favero, Thiago Saikali Farcic

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/27482

Systematic observation is an indispensable tool in clinical neurology evaluation, but data organization and record are extensive and time-consuming, requiring method and training. Reliable scales facilitate this task and technology can be decisive in the implementation of observational data routines. In this study, we aimed to show the experience of a software development to optimize the application of a clinical observational scale. For this proposal it was necessary to consider the needs of the target population, text and image storing and reports generation, using computers with basic configuration, questionnaires and the measurement of time. The software allowed significant reduction in evaluation time and favored the cost-benefit of the task. The proposed methodology was adequate for this type of study.

Open Access Original Research Article

The Effect of Breast Feeding on Eruption of First Primary Tooth in a Group of 6-12 Month Saudi Children

Raghd A. M. Al-Ansari, Nadia M. M. Farrag

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/27498

Eruption of primary teeth is a very important indicator to assess growth and development of the children.

Aim: The present research studied the possible influence of the breast feeding on eruption time of first primary tooth. Also, number of erupting primary teeth in both males and females up to 12 month in relation to type of feeding has been studied.

Study Design: This is an analytic cross sectional study.

Place and Duration of Study: The present sample was selected from 4 primary health care centers in Al-Madinah Al-Monawarah, Kingdome of Saudi Arabia (KSA) between June and July, 2015.

Methodology: A total of 100 healthy children aged between 6-12 month with mean age of (9.26±2.90) month were selected according to cluster random sampling. A questionnaire was completed by direct interview of the children's Mothers. They were asked about the type of feeding (Breast or bottle feeding) they practiced for their children, the eruption age of the first appearing primary tooth in the oral cavity for their children as well as the number of erupted primary teeth.

Results: In breast feeding children the mean time of eruption for first primary tooth was (7.48±1.64) month, while it was (7.17±1.34) month for bottle feeding  with no significant difference, p=0.477. The mean number of erupting primary incisors teeth was lower in group of breast feeding (1.72±1.84) than those in bottle feeding (3.12±2.82) with statistical significant difference (p=0.005). For the whole sample, the mean number of erupting teeth was not affected by the gender. It was (1.98±2.09) for males and (2.15±2.29) for females with no significant difference, p=0.706. Multivariable linear regression analysis demonstrated that Increase in age and bottle feeding were predicators of number of erupted teeth. 

Conclusion: In this group of Saudi Children, breast feeding had no influence on eruption time of first primary tooth. The number of erupting primary incisors teeth was significantly lower in the group of breast feeding than those in bottle feeding. Eruption of primary teeth was not affected by gender.

Open Access Review Article

Biology of Tooth Movement

Anand Sabane, Amol Patil, Vinit Swami, Preethi Nagarajanq

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/27019

Research in the field of cellular and molecular biology is relatively lagging in comparison to mechanical advances in the field of orthodontics. Even though the mechanical advances are used quite carefully during orthodontic tooth movement, traumatic effects on the periodontium have not been totally prevented. This may be because of a lack of complete understanding of the cellular complexities. Proper understanding of cellular and molecular biology will help design mechanics that will produce maximum benefits during tooth movement with minimal tissue damage. The rate of tooth movement depends on the rate at which bone remodels and hence, better knowledge of specific biochemical pathways in individual patients will provide a key to predicting how well teeth respond to mechanical forces. This in turn will provide for better tooth movement and faster treatment procedures.

The pressure tension theory as well as the bioelectric theory have been discussed in detail along with various chemical mediators with the lipo-oxygensase pathway as well as they cyclooxygenase pathway. Role of neurotransmitters and vasoactive amines along with mechano-transduction has been discussed in the review. These predictors, however, need further work to validate reliability.