Open Access Case Report

Mucocele: A Case Report with Etiopathogenesis, Clinical Features and Various Treatment Options

Chaurasia Priya Dayashankar, Sheela Kumar, Usha Hegde

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/28157

A mucocele is a benign, mucous-containing cystic lesion of the minor salivary glands presenting as a distinct, fluctuant, painless swelling of the mucosa. Mucocele is a clinical term used that includes mucous extravasation phenomenon and mucus retention cyst. Because each has a distinctive pathogenesis and microscopy, they are considered separately. Extravasation mucocele is the most common type of the two and the most common reason for mucocele is traumatic injury to the minor salivary ducts. They can appear at any site where minor salivary gland is present. The most common site is lower lip followed by the tongue, floor of mouth and buccal mucosa. There are various modalities for the treatment of mucocele.

This paper reviews a case of extravasation type of mucocele; its etiopathogenesis, clinical features and various treatment options.

Open Access Case Study

Crown Lengthening Procedures after Orthodontic Treatment and before Placement of Prosthetic Crowns

Sandra Olivia Kuswandani, Antonius Irwan, Yuniarti Soeroso, Benso Sulijaya

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/BJMMR/2016/27398

Background: The need to provide aesthetic as well a functional dental restoration continues to be a challenge for the restorative dentistry. Crown-lengthening procedures can help address those challenges and can also be useful to improve the results of orthodontic and pre-prosthetic treatment. Clinical crown lengthening should be based on the adequacy of a biological width of 2.04 mm in order to obtain healthy periodontal tissue.

Purpose: To review crown lengthening procedures used for post-orthodontic and pre-prosthetic treatment, and explain the importance of biological width and its role in dental reconstruction and maintaining healthy periodontal tissue.

Case Report: Case #1 is a crown lengthening procedure performed with gingivectomy alone without bone reduction in the region of 22 in a post-orthodontic treated patient with asymmetric clinical crown and gingiva compared to the region of 12. The procedure resulted in symmetric gingiva and a balanced clinical crown. Case #2 is an example of crown lengthening as a pre-prosthetic treatment prior to crown restoration in the area of 13 and 14. Gingivectomy and bone reduction were both required to obtain adequate crown length.

Discussion: Bone reduction may be required as part of a crown lengthening procedure in order to obtain adequate biological width. To determine the need for bone reduction, the anatomical relationship between alveolar bone and the gingival margin should be assessed prior to treatment.

Conclusion: Clinical crown lengthening can be useful in a variety of clinical situations where form and function need to be reestablished. The key to success for this therapy is proper planning and an adequate amount of attached keratinized gingiva.

Open Access Minireview Article

Studying Chronic Pain in Children and Adolescents: Why is it Important?

Gerasimos Kolaitis

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/28333

Background: Chronic pain not associated with a disease is very common in childhood and adolescence, with prevalence rates between 5-27%, and is considered to constitute a considerable health problem.

Aim: The current update of literature aims at showing why studying chronic pain and related issues in children, adolescents and their families is important.

Methods: Mostly recent (2010-2015) studies of youth chronic pain were included in this update.

Results: This update gives the main findings of mostly recent studies which contribute to our knowledge on chronic pain and its impact on child quality of life, association with child mental health, persistence and consequences in adulthood, family/parental influences and attitudes, and association with parental somatic symptoms.

Conclusion: In studying chronic pain, a holistic approach in the assessment and management, based on the biopsychosocial model, should be considered. More studies in the field are needed, especially in preschoolers from the community, with large numbers of children and adolescents, and a follow-up design.

Open Access Original Research Article

MicroRNA-21 as a Potential Biomarker for Colorectal Cancer Diagnosis: A Meta-analysis

Chao-Hui Zhen, Guo-Jun Yao, Yan Tan, Lu Yang, Xiao-Fang Yu, Fu-Rong Li

Journal of Advances in Medicine and Medical Research, Page 1-13
DOI: 10.9734/BJMMR/2016/27261

Aims: Colorectal cancer (CRC) occupies an important position in the morbidity and mortality constitution of malignancies. In recent years, mounting literature has reported about the upregulating expression of microRNA-21 in blood and stool of CRC patients, which suggested that microRNA-21 may become a novel potential biomarker for CRC. Consequently, this meta-analysis was designed to systematically review the values of microRNA-21 in CRC diagnosis.

Methodology: Databases, including Cochrane library, PubMed, EMbase, Google Scholar, and Chinese National Knowledge Infrastructure, were scanned to retrieve relevant articles focusing on microRNA-21 in CRC diagnosis. Articles were then filtered according to the PRISMA statement and assessed by quality assessment of diagnosis accuracy studies-2. Sensitivity (SEN), specificity (SPE), positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) were pooled using fixed-effects model or random-effects model. Summary receiver operating characteristic (SROC) curve and area under the curve (AUC) were used to estimate the overall diagnostic performance.

Results: A total of 15 studies, comprising 1268 CRC patients and 910 healthy controls, were enrolled in this meta-analysis. For serum miR-21, the pooled DOR, SEN, and SPE were 13.97 (95% CI: 8.44–23.11), 0.73 (95% CI: 0.69–0.77), and 0.83 (95% CI: 0.76–0.89), respectively; for plasma miR-21, the pooled DOR, SEN, and SPE were 8.03 (95% CI: 3.30–19.52), 0.67 (95% CI: 0.60–0.73), and 0.76 (95% CI: 0.69–0.81), respectively; and for fecal miR-21, the pooled DOR, SEN, and SPE were 7.06 (95% CI: 2.17–22.95), 0.33 (95% CI: 0.28–0.37), and 0.91 (95% CI: 0.88–0.93), respectively. Moreover, the AUC values of serum, plasma, and fecal miR-21 in CRC diagnosis were 0.8701, 0.8295, and 0.6742, respectively.

Conclusion: Blood miR-21 demonstrates good diagnostic performance, and serum samples are better than plasma samples in CRC diagnosis. For fecal miR-21, the sensitivity is unsatisfactory, but the specificity is favorable in predicting CRC patients.

Open Access Original Research Article

Cardiopulmonary Changes after Dental Procedures with Adrenaline Containing Local Dental Anesthesia

M. Emara, O. Alhydramy, H. Yamany, A. Badawi, A. Shamaa

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/28226

Background: The injection of adrenaline containing local dental anaesthesia may be associated with variable adverse effects on the cardio- respiratory system that are clinically undetectable.

Methods: The present study was conducted on 60 male patients who received adrenaline containing local dental anaesthesia, and 30 male patients who did not receive local dental anesthesia as a control group. Careful history taking, clinical examination, heart rate, SBP,  DBP, MBP, respiratory rate, spirometry to measure FEV1, PEF, and oximetry to measure O2 saturation before and 15 minutes after dental procedures were obtained.

Results: Our results showed high statistical significant increase in HR, SBP, DBP, MBP, RR, and decrease in O2 saturation, FEV1, and PEF after dental procedures with adrenaline containing local dental anesthesia compared to baseline values in patients group, and a high statistical significant increase in RR only after dental procedures in control group.

Conclusion: Dental procedures with adrenaline containing local dental anesthesia have a stressful effect on the cardio respiratory systems as evidenced by the statistically significant increase in HR, SBP, DBP, MBP, RR, and statistically significant decrease in O2 saturation, FEV1, and PEF after dental procedures compared to baseline values.

Open Access Original Research Article

The Relationships between Mental Health Problems and Family Coping Strategies among Palestinian in the Gaza Strip

Abdelaziz M. Thabet, Sanaa S. Thabet, Panos Vostanis

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/27747

Aim: The aim of the study was to investigate mental health problems and family coping strategies among Palestinians in the Gaza Strip.

Methods: The sample consisted of 449 subjects. The age ranged from 21 to 60 years with mean age 41.5 years. Participants completed Hopkins Symptoms Checklist Scale and Family-Oriented Coping Scale support scale.

Results: The study showed than 52.6% had anxiety, and 50.6% had depression. Females scored more anxiety and depression than males. Mental health symptoms were more in family with family monthly income $300 and less, and in families with 8 and more children. The results showed that mean total family coping strategy was 107.28. Males were significantly reported more coping strategies, including acquiring social support, reframing, seeking spiritual support, and mobilizing family to acquire and accept help. Total HSCL score was negatively correlated with total family coping strategies, acquiring social support, reframing, seeking spiritual support, and positive appraisal.

Conclusion: The study reported high rates of anxiety and depression which had negative impact on Palestinian families coping strategies. Psychologists, educators, social workers and community workers should support families to identify shortcomings in their coping and to help develop their latent resources.

Open Access Original Research Article

Prevalence and Predictors of Pap-Smear Screening for Cervical Cancer among Married Women in Urban of Mandalay, Myanmar

Chit Pyae Pyae Han, Htoo Htoo Kyaw Soe, Nan Nitra Than, Htay Lwin, Soe Moe

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/28156

Aims: To determine the prevalence of Pap-smear screening, to assess the knowledge regarding cervical cancer and Pap-smear test and to identify the predictors of practice of Pap-smear screening among married women in urban of Mandalay, Myanmar.

Study Design: Cross-sectional study.

Place and Duration of Study: This study was done in urban townships in Mandalay, Myanmar from February–March, 2012.

Methodology: 230 married women were selected using multistage sampling. Interviews were conducted using structured questionnaire by five research assistants. Questionnaire consisted socio-demographic characteristics, past Pap-smear practice, knowledge and perception towards cervical cancer. Practice of Pap-smear screening was defined as ever had a test in life time.

Results: Of 230 married women, only 38 (16.5%) had reported history of Pap-smear test in their life time of whom 71.1% had the test within last 1 year and 5.2% had within last 3 years. Logistic regression analysis shows that the likelihood to perform Pap-smear screening test was higher in woman age between 36-45 years (adjusted OR = 34.79; 95% CI = 7.1 – 170.2) and woman more than 45 year of age (adjusted OR = 10.1; 95% CI = 1.9 – 51.8). Woman who got married at 20-25 year-old (adjusted OR = 16.4; 95% CI = 1.9 – 142.6) and more than 25 year-old (adjusted OR = 9.5; 95%CI = 1.2 – 75.2) are more likely to have screening compared to woman got married at age of under 20 years.  Women having good perception (adjusted OR = 14.5; 95% CI = 3.9 – 53.9) and whose husband were aware about cervical cancer and Pap-smear screening test (adjusted OR = 46.1; 95%CI = 9.7 – 219.6) were significant predictors of having Pap-smear test.

Conclusion: Poor knowledge for cervical cancer and lack of self-care knowledge are immediate concerns to reduce the morbidity as well as mortality of cervical cancer among Myanmar married women.

Open Access Original Research Article

Meta-analysis of Drop out Rates in Cataract Surgery RCTs - An Update

Christine Baulig, Stephanie Knippschild, Frank Krummenauer

Journal of Advances in Medicine and Medical Research, Page 1-17
DOI: 10.9734/BJMMR/2016/28190

Aims: A realistic sample size calculation is an essential step in planning a clinical trial. It includes the consideration of the expectable drop out profile during individual patient observation periods to ensure a sufficient sample size for statistical analysis. Aim of this meta-analysis was to estimate dropout rates for randomized controlled trials (RCT) on cataract surgery during a follow–up period of 6 and 12 months in order to optimize sample size calculation.

Methodology: A full text hand search in five ophthalmological journals (publication period 01/2002 – 12/2012) for RCTs on cataract surgery was performed. The meta-estimation of the reported 6 and 12 months drop out rates was based on the random effects model and stratified for the trial design characteristic “comorbidities allowed by design”.

Results: 35 RCTs reporting no comorbidities (total patient count n=3.055) and 9 RCTs reporting comorbidities by design (n=8.631) met the inclusion criteria for the 6 months follow-up evaluation; 41 RCTs without comorbidities (n=3.384) and 7 RCTs allowing for comorbidities (n=1.082) were identified for the 12 months follow-up evaluation. Respective and 12 months meta drop out rates of 7.8% (95% CI 5.0 – 11.8%) and 16.3% (95% CI 13.2 – 20.0%) were estimated from RCTs without comorbidities. RCTs allowing for comorbidity by design demonstrated lower drop out estimates with 3.2% (95% CI 2.9 – 3.6%) after 6 months follow-up and 6.7% (95% CI 3.9 – 11.2%) after 12 months.

Conclusion: Sample size calculation in cataract surgery should account for drop outs rates of at least 10% during a 6 months and of at least 20% during a 12 months follow-up period.

Open Access Original Research Article

Predictors of Health-related Quality of Life and Self-care in a Large Sample of Spanish Adults with Diabetes Mellitus

Clara Marcuello, Carmen Montañez, Borja Muñoz, Ester Montenegro, Isabel Calvo, Consuelo Auñón, Amparo Sabaté, Laura del Valle, Manuel Fuentes Ferrer, Carla Assaf-Balut, Isabelle Runkle, Miguel Angel Rubio, Alfonso Luis Calle-Pascual

Journal of Advances in Medicine and Medical Research, Page 1-17
DOI: 10.9734/BJMMR/2016/28245

Objective: To assess health-related quality of life (HRQoL) and self – care behaviors in a large sample of diabetic patients (DPts) and to examine which patients’ characteristics influence on them.

Methods: This cross - sectional study included 1,039 DPts (561/478, Men/Women, 156/883 DM1/DM2, mean age 62±15 years old; mean diabetes duration 15±10 years) evaluated in a diabetes (DM) specialized outpatient office, at St Carlos Hospital, in Madrid, from 2012 to 2014. HRQoL was assessed with the EuroQoL- Visual Analogue Scale (EQoL-VAS) and the Diabetes Quality of Life Score (DQoL). Treatment adherence was evaluated using the Self-Care Inventory-revised (SCI- r). Multiple logistic regression analysis were used to examine the relationship between HRQoL, adherence to treatment and several demographic and clinical patients’ characteristics.

Results: A lower quality of life was associated with the female gender, the presence of chronic complications and a poor glycemic control (all p < 0, 05). After adjustment for confounders, obese middle-aged men showed the lowest adherence to treatment. However, women with a prolonged duration of the DM (> 15 years) and DPts receiving insulin treatment showed a better DM self-care (p <0.05).

Conclusions and Implications: The duration of the DM, metabolic control, the type of therapy, and the presence of chronic complications are important determinants of HRQoL and treatment adherence in patients with DM, and should be taken into account when treating DPts. Data obtained could be useful to plan patient-based health decisions.

Open Access Original Research Article

Applying the Health Belief Model Constructs to Determine Predictors of Dietary Behavior among High-School Students

Salahshouri Arash, Harooni Javad, Daniali Seyde Shahrbanoo, Pourhaji Fatemeh, Moradi Maryam, Sheida Sepahi

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/27875

Introduction: Healthy nutrition during adolescence and adulthood, compared with childhood, is considered important since the basal metabolic rate decreases with age and there is often a reduction of physical activities. Furthermore, educational achievement is dependent on a healthy diet. Therefore, the present study investigated predictors of dietary behavior on the basis of the Health Belief Model (HBM) among high-school students in Kermanshah, Iran.

Materials and Methods: This cross-sectional study was both descriptive and analytical. The multistage random sampling method was applied and 500 high-school students (250 male students and 250 female students) were selected. The research tool was a two-part questionnaire, including questions about personal information and a healthy diet. Descriptive and analytical tests were conducted using the SPSS18 software.  

Results: The most important predictor of the students’ healthy dietary behavior was perceived benefits. Perceived barriers and self-efficacy were not effective predictors. Moreover, there was a positive and significant relationship between healthy-diet patterns and perceived self-efficacy as well as perceived barriers. The mean score of self-efficacy for a healthy diet among the male students was significantly higher than among the female students (P < 0.001).

Discussion and Conclusion: The results of the present study indicate that some of the HBM constructs are sufficient for detecting the predictors of dietary behavior. Therefore, other psychosocial models should be considered for changing dietary behavior among students.