Integrative Journal of Medical Sciences https://mbmj.org/index.php/ijms <p><strong>Integrative Journal of Medical Sciences (ISSN: 2658-8218)</strong>, formerly <a href="https://eresources.loc.gov/record=b2588499~S2">International Journal of Medicine and Surgery (ISSN: 2336-0313),</a> is an international open-access journal, based on a continuous publication model, and aims to publish original works covering all Medical Sciences fields.</p> en-US contact@mbmj.org (Integrative Journal of Medical Sciences) ( ) Sat, 09 Jan 2021 00:00:00 +0000 OJS 3.3.0.8 http://blogs.law.harvard.edu/tech/rss 60 Psychological Support and Telehealth Options for Patients with Cancer during the Covid-19 Pandemic in Saudi Arabia https://mbmj.org/index.php/ijms/article/view/487 <p><strong>Background:</strong><strong> </strong>COVID-19 concerns are associated with an increase in symptoms of depression and anxiety among cancer patients. Telehealth services hold incredible potential for providing psychological support to cancer patients. In a technology-assisted intervention for telehealth, hotline services are a valuable tool to provide psychosocial care. This paper examines the use of hotline services to offer psychological support to cancer patients.<br /><strong style="font-size: 0.875rem;">Methods:</strong><strong style="font-size: 0.875rem;"> </strong><span style="font-size: 0.875rem;">A retrospective analysis of hotline calls patient registry data was conducted. Data were collected from a single cancer center in Riyadh, from May 2020 to March 2021, with a random sample of 877 callers to cancer hotline services. Responses of a satisfaction questionnaire were linked to call-related concerns of registry data. <br /></span><strong style="font-size: 0.875rem;">Results:</strong><span style="font-size: 0.875rem;"> A total of 877 calls were received, the majority of which came from Riyadh locals. Patient disease complaints accounted for 210 calls (24%), while retake medicine requests accounted for 251 calls (28.62%). 143 (16.31%) calls were about scheduled new appointments, 261 calls (29.76%) were about psychological issues induced by Covid-19, such as worry, fear, and anxiety symptoms, and 12 calls (1.37%) having to do with Covid-19. Seven hundred seventy-two callers (88 %) indicated satisfaction with the services call attended.<br /></span><strong style="font-size: 0.875rem;">Discussion:</strong><span style="font-size: 0.875rem;"> Hotline services in cancer care have been identified as a key resource telehealth service that positively influences patient satisfaction and meets cancer patient needs in the face of the pandemic. This study also highlighted the need for other telehealth services, such as mental health mobile applications, virtual multidisciplinary care, and online support groups, which can provide an excellent option for providing psychological support to cancer patients.<br /></span><strong style="font-size: 0.875rem;">Conclusion:</strong><span style="font-size: 0.875rem;"> This study found that providing Cancer Care Hotline services during a pandemic improves patient-centered care and a more efficient healthcare delivery system.</span><strong style="font-size: 0.875rem;"> </strong></p> Manal Banaser, Sami Alshammary Copyright (c) 2021 Manal Banaser et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/487 Wed, 08 Sep 2021 00:00:00 +0000 Perspectives on Fewer Sars-2 Corona virus (COVID-19) Deaths in Africa https://mbmj.org/index.php/ijms/article/view/427 <p>Globally, more than two million people, about 53,000 in Africa have died from COVID-19 infection. By any metric, Africa has so far fared better than most parts of the world including, some of the most developed and affluent nations like the United States of America in the fight to contain the COVID-19 pandemic. Analysis of published COVID-19 data shows that Africa, with a population four times greater than that of the United States recorded forty times less number of positive cases and at least thirty fold decrease in the number of COVID-19 deaths. The data also demonstrates that the population case positivity and fatality rates in Europe are respectively ~24 and ~23 folds greater than those of Africa. The vast disparity in the metrics between advanced nations in Europe and the United States, with substantial healthcare budgets and the developing nations of Africa is worth examining.&nbsp; In this article, we offer some perspectives to explain Africa’s low case positivity and death rates from COVID-19 infections. While many factors contribute to the world’s collective vulnerability to the pandemic, structural, demographic and sound public health policy together are essential in fighting off the disease.</p> William A Anong, Jude N. Okoyeh Copyright (c) 2021 Anong WA & Okoyeh JN https://mbmj.org/index.php/ijms/article/view/427 Wed, 07 Apr 2021 00:00:00 +0000 Characteristics and Associated Factors of Burn-out among Moroccan Dentists https://mbmj.org/index.php/ijms/article/view/550 <p><strong>Objective: </strong>Burnout is a real threat for healthcare professionals and is growing exponentially in our modern societies. Our study aims to determine the prevalence of burnout among dentists in Rabat, Sale, and Kenitra region and look for the associated factors.<br /><strong style="font-size: 0.875rem;">Method:</strong><span style="font-size: 0.875rem;"> This is a descriptive and analytical cross-sectional epidemiological study carried out in 2019 with a group of 120 dentists using a self-administered questionnaire; burnout was assessed by the French version of the Maslash Burnout Inventory (MBI).<br /></span><strong style="font-size: 0.875rem;">Results:</strong><span style="font-size: 0.875rem;"> A total of 100 dentists participated in the study (response rate of 83.33%) with a female predominance at 56% and an average age of 38 years. Severe burnout affected 25% of participants, and only 3% presented low burnout for all three dimensions (According to Maslach's Burnout Inventory). The percentages of the MBI sub-dimensions were as follows: 47% had high emotional exhaustion, 51% had high depersonalization, and 42% had low personal fulfillment. High depersonalization was associated with unmarried status (p = 0.019) and working alone (p = 0.002).<br /></span><strong style="font-size: 0.875rem;">Conclusion:</strong><span style="font-size: 0.875rem;"> 25% of the dentists in our study were affected by severe burnout, which presents a worrying result proving that burnout is a reality in our country. The contributing factors were working alone in the office and being unmarried, and the essential protective element seemed to work in association.</span></p> Anissa Regragui, Sohayb El Harfaoui, Loubna Bahijie, Najib Al Idrissi, Faiza Benfdil , Nadia Merzouk Copyright (c) 2021 Anissa Regragui et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/550 Tue, 28 Sep 2021 00:00:00 +0000 The Correlation between Functional Parameters (6-Minute Walk Test) and Life Quality of Silicosis Patients: Case Study in the Jerada City in Morocco https://mbmj.org/index.php/ijms/article/view/491 <p><strong>Introduction: </strong>Silicosis is pneumoconiosis secondary to the inhalation of mineral dust containing silica. It represents a real public health problem in the city of Jerada.<br /><strong style="font-size: 0.875rem;">Purposes:</strong><span style="font-size: 0.875rem;"> To assess the functional parameters of silicosis patients (based on the 6-minute walk test (6MWT)) and their impact on our patients' quality of life (Saint George's respiratory questionnaire (SGRQ) and hospital anxiety and depression scale (HAD)).<br /></span><strong style="font-size: 0.875rem;">Materials and methodology:</strong><span style="font-size: 0.875rem;"> This is a cross-sectional study of 147 patients with silicosis, designed to collect their socio-demographic data, to assess their respiratory function (6MWT) and their quality of life (SGRQ).<br /></span><strong style="font-size: 0.875rem;">Findings:</strong><span style="font-size: 0.875rem;"> The average age of our patients was 64.08 +/- 6.46 years [46 -81]. At 6MWT, the mean distance walked by our patients is 326.8 +/-168.47 m (30 - 835) or 59% of the predicted distance, with a median of 360m. The mean total Saint George score (SGT) was 68.02 +/- 19.54%. The means of the other Saint George scores were: symptoms (SGS): 45.95 +/- 23.66%, activities (SGA): 79.58 +/- 19.8%, and impact (SGI): 68, Results: The average age of our patients was 64.08 +/- 6.46 years [46 -81]. At 6MWT, the mean distance walked by our patients is 326.8 +/-168.47 m (30 - 835) or 59% of the predicted distance, with a median of 360m. The mean total Saint George score (SGT) was 68.02 +/- 19.54%. The means of the other Saint George scores were: symptoms (SGS): 45.95 +/- 23.66%, activities (SGA): 79.58 +/- 19.8%, and impact (SGI): 68.32 +/- 22.33%. We found a statistically significant relationship between dyspnea, quality of life, anxiety and walking distance.<br /></span><strong style="font-size: 0.875rem;">Conclusion:</strong><span style="font-size: 0.875rem;"> The study demonstrated that silicosis is a pulmonary disease which causes significant functional limitation and deterioration of life quality.</span></p> Meryem Karhate Andaloussi, Lamiyae Senhaji, Michele Germain , Jean-Marie Casillas, Abderrazak Hajjioui Copyright (c) 2021 Meryem Karhate Andaloussi et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/491 Mon, 04 Oct 2021 00:00:00 +0000 A Beumer Classification of Labial-alveolar-palatal Clefts: Suggestion for Complement https://mbmj.org/index.php/ijms/article/view/465 <p>Orofacial clefts are a common birth defect characterized by involvement of the nasal and oral structures. Several classifications of orofacial clefts have been proposed in the aim of generalizing rational criteria allowing communication and exchange between the different practitioners. Among these classifications, the classification of Beumer has got surgical and prosthodontic interest (making an orthopedic plate).<br />The authors propose to update this classification by modifying it and proposing a class that did not exist in the original classification. This modification seems important to us as a complement to this classification.</p> Wijdane El Hawari, Abdoulmajid Habibou , Nadia Merzouk , Oussama Bentahar Copyright (c) 2021 El Hawari W et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/465 Thu, 19 Aug 2021 00:00:00 +0000 Evaluation of Drug Use Practices Using WHO Core Drug Use Indicators at Pediatric Health Facilities, Kabul, Afghanistan https://mbmj.org/index.php/ijms/article/view/479 <p><strong>Background: </strong>Irrational medicine use is a global problem. It can lead to increased morbidity and mortality and increased costs of drug therapy, thus imposing an adverse impact on the overall quality of the pharmaceutical care system. <strong>Objective: </strong>To evaluate drug use practices based on WHO core drug use indicators at pediatric health facilities of Kabul, Afghanistan.<br /><strong>Methods: </strong>A cross-sectional study was conducted at outpatient departments of the three pediatric health facilities at samples that were collected using a systematic random sampling method. The sample size included 600 outpatient prescriptions. Data were evaluated as per the WHO guidelines.<br /><strong>Results: </strong>On average 2.795, 2.745, and 4.2 drugs per prescription were prescribed in 001, 002, and 003 health facilities respectively (WHO standard is 1.6-1.8). 37.03% of drugs in 001, 42.62% in 002, and 42.64% of drugs in 003 were prescribed by the generic name (WHO standard is 100%). Antibiotics were prescribed in 79% prescriptions of the 001, 88% of the 002, and 52% of the 003 health facilities (WHO standard value is 20-26.8%). Injections were prescribed in 6% of the 001, 32% of the 002, and 19.5% of the 003 prescriptions (WHO standard is 13.4-24.1%). 65.47% of drugs in 001, 67.94% of drugs in 002, and 73.1% of drugs in 003 health facilities were prescribed from the Afghanistan national essential medicines list (WHO standard is 100%).<br /><strong>Conclusion: </strong>Most of the core drug use indicators were not met with WHO standards in these pediatric health facilities. However, in 001 and 003 health facilities the prescribing patterns may be more complex because they are tertiary health care centers.</p> Ahmad Farid Habibyar, Hafiza Hamid, Nesar Ahmad Zahier, Qand Agha Nazari, Neha Sharma, Navneet Khurana Copyright (c) 2021 Ahmad Farid Habibyar et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/479 Tue, 13 Jul 2021 00:00:00 +0000 Non-Invasive Ventilation in Infants Attending a Tertiary Care Center: A Retrospective Review https://mbmj.org/index.php/ijms/article/view/405 <p>Bronchiolitis was found to be the greatest worldwide cause of infant hospitalization presenting with symptoms of cough, wheezes, difficulty in breathing, decreased feeding, and apneas. It is estimated that 1-3% of hospitalized infants will require treatment in an intensive care unit especially when risk factors are present. This study analyzes the use of Non-invasive ventilation (NIV) in severe bronchiolitis and its role in reducing the rate of ventilator associated pneumonia (VAP), and the duration of oxygen requirement. Data were collected retrospectively through PHENIX; hospital electronic system for infants less than one year old. Shortness of breath, cough, apnea, cyanosis, N-CPAP immediate or later after few hours, mechanical ventilation (MV), length of hospital stay, and survival status were the outcome variables. Mann-Whitney U test was performed via SPSS version 25.0.Fifty-five infants with bronchiolitis were admitted with forty-nine episodes receiving NIV or MV. A total of thirty-seven infants were treated with NIV while 15 infants were treated with MV. Fever was the major indication for initiating NIV among infants followed by cough, apnea, and shortness of breath. Insignificant evidence was reported between baseline respiratory parameters and infants receiving NIV and MV. Changes in respiratory variables in the first four hours showed significant increase for infants receiving NIV than those receiving MV. Infants receiving NIV had significantly fewer days in NIV and PICU, but insignificant fewer days in hospital stay. The experience for using NIV in infants admitted for bronchiolitis recommends that NIV might be adjunct to mechanical ventilation. This strategy was related with a lower rate of pneumonia and a shorter duration of oxygen therapy.</p> Shafiqa Alsharif Copyright (c) 2021 Shafiqa Alsharif https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/405 Mon, 02 Aug 2021 00:00:00 +0000 The Characteristics of Women Aged 59-64 Years Who Consult Health Care Practitioners for Back Pain from the Australian Longitudinal Study on Women's Health (ALSWH) https://mbmj.org/index.php/ijms/article/view/324 <p><strong>Background: </strong>Back pain affects a substantial proportion of the adult population, and back pain sufferers tend to explore a wide range of health care options. This study investigates the use of medical and physiotherapy services by Australian women with back pain. <br /><strong style="font-size: 0.875rem;">Method: </strong><span style="font-size: 0.875rem;">This is a sub-study of the Australian Longitudinal Study on Women's Health (ALSWH), designed to investigate multiple factors affecting the health and well-being of women over a 20-year period. The study focuses on 1,851 women aged 59-64 years, who had indicated that they had previously sought help from a health care practitioner for back pain.<br /></span><strong style="font-size: 0.875rem;">Results: </strong><span style="font-size: 0.875rem;">Half of the women (56.5%) with back pain had consulted a general practitioner (GP), 16.2% had consulted a medical specialist, and 37.3% had consulted a physiotherapist for their back pain. Women with regular or continuous back pain were more likely to consult a GP (OR=3.98), medical specialist (OR=5.66) and a physiotherapist (OR=1.63).<br /></span><strong style="font-size: 0.875rem;">Conclusion: </strong><span style="font-size: 0.875rem;">Australian women with back pain were more likely to consult a GP, medical specialist or physiotherapist if they had more regular/continuous back pain. Future research needs to investigate further the consultation and referral patterns identified in this study.</span></p> Pooja Maddela, Jane Frawley, Jon Adams, David Sibbritt Copyright (c) 2021 Pooja Maddela et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/324 Mon, 02 Aug 2021 00:00:00 +0000 Functional Outcomes in Suprapatellar Nailing for the Treatment of Tibial Shaft Fractures https://mbmj.org/index.php/ijms/article/view/579 <p><strong>Introduction: </strong>The purpose of this study was to evaluate the functional outcomes of suprapatellar intramedullary nailing for the treatment of tibial shaft fractures.<br /><strong>Material and Methods: </strong>The present retrospective study included 10 cases aged more than 20 years, who were operated for tibial shaft fractures over the last 3 years with suprapatellar tibial nailing. Patients were retrospectively followed up with all their previous surgical records and radiographs.<br /><strong>Results: </strong>The mean age was 41.57±16.51 with a range of 20-72 years. The mean operating time was 81±10.15 minutes. Mean blood loss was 110±20.5 ml. Meantime for the union was 15.15±1.35 weeks. No deep infection was noted. 1 patient had anterior knee pain. The mean Lysholm knee score was 87.91 ± 5.75.<br /><strong>Conclusion: </strong>The suprapatellar approach is good and safe technique for nailing in the tibial fractures.</p> Abhishek Garg, Aman Saini, Aditya Seth, Ipanshu Malik, Rahul Sharma, Ram Krishna Mishra Copyright (c) 2021 Abhishek Garg et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/579 Mon, 11 Oct 2021 00:00:00 +0000 Burden and Trends of Leishmaniasis over the last one Decade Across the Globe: Trend Analysis of WHO Regions https://mbmj.org/index.php/ijms/article/view/295 <p style="text-align: justify;"><strong>Introduction: </strong>In terms of the global burden of diseases, leishmaniasis is the third most serious and often fatally untreated tropical disease. The number of people suffering from leishmaniasis is estimated to be 12–15 million. Because of the comparatively underestimated reported number of cases, leishmaniasis is not seen as an immediate health issue in various regions by local and international health policymakers. Therefore, strong evidence is required for policymakers to make decisions. Therefore, we aimed to conduct secondary data analysis to assess the trends of Leishmaniasis over the last decade and understand the endemicity of different regions for Leishmaniasis across the world. <strong>Methods: </strong>&nbsp;We undertook a retrospective study with secondary data analysis of the WHO data from 2008 to 2018, publicly available, for cutaneous and visceral Leishmaniasis. The data for around 194 countries were included in the analysis and these countries were merged into different regions based on the WHO classification. We categorized all 94 countries into regions such as America, Europe, Africa, South-East Asia, the Eastern Mediterranean, and Western Pacific. Since the data were limited to the frequency of cases and there were no other variables, therefore, we were able to do the descriptive analysis. <strong>Results: </strong>Generally, the number of cutaneous Leishmaniasis cases has declined for all regions except for the Eastern Mediterranean region. A declining trend of imported cases of cutaneous Leishmaniasis was found for all regions mainly from 2015 to 2018. The cases of visceral leishmaniasis in the Eastern Mediterranean region, Africa, America, and Europe have remained stable. However, after remaining stagnant for about four years, the number of visceral leishmaniasis in South Asia showed a steep decline. Of the 194 countries, 76.39% are considered as endemic for cutaneous Leishmaniasis and 44.3% are considered as endemic for visceral Leishmaniasis.<strong> Conclusion: </strong>Though cases of Leishmaniasis have decreased over the past decade, regions need to make efforts to capture the true number of cases with an effective surveillance system. There appears to be a stable trend in most countries, although it is unclear whether that trend is due to regulation steps taken by various governments or to cases being underreported. Governments in various regions therefore need to make efforts to identify true cases and to take effective control steps.</p> Hend Alatif Copyright (c) 2021 Hend Alatif https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/295 Tue, 08 Dec 2020 00:00:00 +0000 Impact of Visiting Community-Based Psychosocial Support Centres on the Well-Being of Cancer Patients: Exploration of Evaluation and Effects https://mbmj.org/index.php/ijms/article/view/311 <p><strong>Aim: </strong>Community-based psychosocial support centres for cancer patients and their relatives (CBPSCs) in the Netherlands offer easily accessible contacts with fellow patients and support by trained volunteers and/or professionals. We studied if the participants in the social support and/or therapy activities are satisfied with these services and if the visits do affect their well-being in terms of bodily and emotional health and their health quality of life (HQoL).<br><strong>Methods:</strong> &nbsp;In 25 CBPSCs, 701visitors filled out a web-based questionnaire about&nbsp; their experiences with CBPSCs. Within this sample, 203 participants answered a part of the questionnaire again after 3-5 months about their personal characteristics, the type participation &nbsp;at the visits, their satisfaction with the offered activities, the experienced health complains, and&nbsp; three HQoL questions of the EORTC measure.<br><strong>Results:</strong> The study confirms the significance of CBPSCs contacts with fellow patients, resulting in satisfaction with the increased communication about their illness and talks about their problems. The results show further that after a 3-5 months the health complains did not change, but the HQoL decreased significantly for all&nbsp; visitors, except &nbsp;for more serious ill patients in comparison with less ill patients.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<br><strong>Discussion and conclusion</strong> CBPSCs play an important and highly evaluated role in psycho-oncological support. The visit for serious ill patients may function as a buffer for preventing the decrease of their HQoL. Insight in effects of such visits is still limited in other studies. Differences in the health care organization restrict the comparability with the CBPSCs in other countries. More studies are needed to show the long-term effects of CBPSCs visits.</p> Adriaan Visser Copyright (c) 2021 Visser A https://mbmj.org/index.php/ijms/article/view/311 Mon, 21 Dec 2020 00:00:00 +0000 Role Of Multidetector CT in Evaluation of Benign Focal Liver Lesions in a Tertiary Care Centre in North India https://mbmj.org/index.php/ijms/article/view/340 <p><strong>Introduction:</strong> Introduction of Multi Detector computed Tomography has been a huge leap in the CT technology. MDCT has a high diagnostic accuracy, sensitivity and specificity in the evaluation of focal and diffuse lesions of liver. The present study aimed to study the role of MDCT as a diagnostic modality for the benign lesions of liver. <strong>Material and methods:</strong> A prospective study of the role of MDCT in detecting and characterizing neoplastic hepatic lesions was conducted in the period in radiology department of RMCH, Bareilly. Thirty patients, with hepatic benign lesions, were selected. Diagnosis was confirmed by surgery and histopathology, follow up imaging and other non-radiological investigations. <strong>Results:</strong> Thirty patients were finally included as they were found to have benign lesions. Mean age of the patients was 49.8 years. 37% patients aged between 41 and 50 years while 17% patients were elderly. 63% were females. 63% patients had alcohol abuse while 60% were smokers. The most common presenting complaint was pain abdomen (n=15) followed by abdominal discomfort (n=13). Total of 29 lesions were identified on MDCT. The most common lesions were hemangioma (n=15) &nbsp;followed by simple cyst (n=5). <strong>Conclusion:</strong> MDCT is “The Imaging Modality of choice” in characterizing benign hepatic lesions.</p> Tarun Narang, Shweta, Chiranjeev Gathwal, Shailley Copyright (c) 2020 Narang T et al. https://mbmj.org/index.php/ijms/article/view/340 Mon, 21 Dec 2020 00:00:00 +0000 Examination of Bronchial Reactivity in Workers Exposed to Microparticles PM2.5 and PM10 during Coal Surface Mining in the Bellaqevc Power Plants of Kosovo https://mbmj.org/index.php/ijms/article/view/343 <p>The impact of air pollution with microparticles (PM<strong><sub>2.5 </sub></strong>and PM<strong><sub>10</sub></strong>) on the respiratory systems of workers engaged in thesurface mining of coal at the Bellaqevc power plants of Kosovo&nbsp; is studied&nbsp; in this paper. The parameters of lung functionare defined via body plethysmography. The resistance of the airways (Raw) was recorded, intrathoracic gas volume (ITGV) was measured, and the specific resistanceof the airways (SRaw) and specific conductance (SGaw) were calculated. The research was performed withintwo groups: a control group and experimental group. The control group consisted of 28 healthy people, whereas the experimental group consisted of 50 workers engaged in the surface mining of coal at the Bellaqevc power plants of Kosovo.</p> <p>The results obtained from this research indicated that the mean specific resistance (SRaw) was ​​significantly increased in the experimental group (p&lt;0.01) compared to the control group (p&gt;0.1). The study also found that smoking favors the adverse effects of air pollution caused by coalsurface mining at the Bellaqevc power plants (p&lt;0.01).</p> <p>Measurements of the respiratory systems were made prior to and following provocation with histamine–aerosol (1 mg/ml) in the control and experimental groups. Changes between these two groups following this provocation with histamine–aerosol were found to be statistically significant (p&lt;0.01).</p> <p>In order to cause a respiratory pathology from air pollution, it is required a lot of time, such pollution can permanently cause respiratory system disorders. These scientific findings suggest that the long-term exposure of workers to microparticles PM<strong><sub>2.5</sub></strong> and PM<strong><sub>10</sub></strong> during the processof surface mining coal at the Bellaqevc power plants of Kosovo&nbsp; poses a risk to their health by causing increased bronchial reactivity, bronchial asthma, orchronic obstructive pulmonary disease (COPD).</p> Pëllumb Islami, Ali Iljazi, Hilmi Islami Copyright (c) 2021 Islami P et al. https://mbmj.org/index.php/ijms/article/view/343 Tue, 05 Jan 2021 00:00:00 +0000 The Effect of Educated Platelets on the Healing Process of Burn Wounds in Rats: Educated Platelets in Rat Burn Wound Healing https://mbmj.org/index.php/ijms/article/view/344 <p>Burns are serious life-threatening health problems. This study was performed to determine the effect of educated platelets on burn wound healing process. 28 female wistar albino 200-220 gr rats were randomly divided into four groups. Group A1 rats(n:7) were the first-line burnt group from which blood samples are extracted to develop platelet-rich plasma(PRP) with the educated platelets that have a response to burn injury. Group B1 rats(n:7) were the unburnt group with ordinary platelets. Group A2 rats(n:8) were the second-line burnt group which was given PRP with educated platelets. Group B2 rats(n:6), as control group, were the second-line burnt group which was given PRP with ordinary platelets. Photos of rats' dorsum were taken by digital camera on the first day and 21<sup>st</sup> day of the study. Wound healing was determined by scar surface area. In the study group (Group A2) mean wound area was&nbsp; 53±37 mm², in the control group (Group B2) mean wound area was 114±55 mm² on the last day of the experiment. The sizes of the wounded areas were significantly lower in the study group compared with the control group (p: 0.039). Educated platelets seem to facilitate the recovery period of burn wound healing in rats.</p> Orkun Ilgen, Sefa Kurt, Osman Yilmaz, Murat Celiloglu Copyright (c) 2021 Orkun I et al. https://mbmj.org/index.php/ijms/article/view/344 Wed, 06 Jan 2021 00:00:00 +0000 Effect of Accelerating Aging on Retention and the Release Period of Clips in a Bar Retained Maxillary Implant Overdenture https://mbmj.org/index.php/ijms/article/view/385 <p><strong>Objectives:</strong> This study was made to detect the effect of accelerating aging on retention and measuring the release period of clips in a 2 and 3 bar retained maxillary implant overdenture.&nbsp;<br><strong>Materials and Methods:</strong> Four implants were placed in two maxillary edentulous epoxy models. One model had two bar attachments with two clips overdenture while the other model had three bar attachments with three clips in the overdenture. Retention and release period of the clips were checked before applying insertion removal cycles. Retention was measured using a universal testing machine after 540 cycles (6 months) and 1080 cycles (1 year) of insertion removal on a chewing simulator.<br><strong>Results and Conclusions:</strong> There was a significant difference in retention and release period between two bars and three bars implant retained maxillary overdentures. A significant difference was also seen in each group after accelerated aging. Therefore, the three bar implant retained overdenture had higher retention values than two bar. Retention loss occurred in both groups after the insertion removal cycles. Release period value was lower in two bar overdenture than three bar overdenture.</p> Dalia El Naggar, Ahmed Mohamed Alam-Eldein, Maha Mostafa Halim, Hoda Mohammed Amin Rashad Copyright (c) 2021 El Naggar D et al. https://mbmj.org/index.php/ijms/article/view/385 Mon, 18 Jan 2021 00:00:00 +0000 The Balance between Oral Health Needs and Supply Induced Demand in Welsh Dental Services https://mbmj.org/index.php/ijms/article/view/368 <p><strong>Introduction:</strong> Reducing social inequality along with oral health inequality in Wales is a policy objective. In this ecological study the relationships between deprivation, dental workforce and oral health are explored. <br><strong>Method:</strong> Twenty two Unitary Authorities (UAs) serving the population of Wales were studied. The number of dentists were obtained from NHS Business Services as well as the 2019 population figures from StatsWales. As data for whole time equivalent General Dental Practitioner (GDP) workforce were not available, GDP sites were used. The condition of teeth at the age 12 years was used as a measure of oral health from the most recent epidemiological survey available. The relationship between oral health and workforce was established using the Welsh Index of Multiple Deprivation (WIMD).<br><strong>Results:</strong> Associations were observed between dental sites and population as well as between oral health and deprivation. A new composite variable called the University of South Wales Dental Index (USWDI) was introduced by combining the number of dentists with their corresponding WIMD of the most deprived 10% of the population. Using regression modelling the USWDI demonstrated its superiority in using either the number of dentists or the WIMD most deprived 10% alone to predict decayed, missing and filled teeth (DMFT).<br><strong>Conclusion:</strong> Workforce levels have increased and there has been a corresponding improvement in oral health over two decades. At the same time deprived subgroups continue to experience relatively higher levels of disease. A proportion of the general dental services delivered in Wales has continued to be based on the principle of supply induced demand for care rather than oral health need. Improving oral health in a diverse population like Wales cannot be achieved by increasing dental workforce alone. It is necessary to account for levels of deprivation. USWDI as a predictor of DMFT could be a useful tool to monitor the macro delivery of oral health care for the future in Wales.</p> Wayne Richards, Jamal Ameen, Anne-Marie Coll, Teresa Filipponi Copyright (c) 2021 Richards W et al. https://mbmj.org/index.php/ijms/article/view/368 Fri, 15 Jan 2021 00:00:00 +0000 Kinesio Tape 14-Day Application Cycle: A Case Study https://mbmj.org/index.php/ijms/article/view/392 <p>This study utilized a 14-day application cycle of Kinesio tape which is a longer version of the current application period with the goal to extend the effect of the treatment on the immediate effect on perceived pain, pain free range of motion, overhead squat analysis, and the athlete’s perceived performance. Kinesio Tape was applied to the athlete for five days, and then removed for a two-day rest period and then repeated. Pre/post-assessments consisted of an overhead squat analysis, pain free range of motion of the hip, knee, and ankle, perceived pain, and perceived performance. There was a significant increase in pain free range of motion for two of the eight joint actions assessed [left hip internal rotation (p=0.03) and left ankle plantarflexion (p&lt;0.01)].&nbsp; Furthermore, participants significantly improved their overhead squat assessment score from pre (5.4±1.8) to post (3.5±1.8) Kinesio Taping (p&lt;0.01).<strong>&nbsp; </strong>Lastly, participants reported a significantly lower level of perceived pain (p&lt;0.01) and a significantly higher level of perceived performance (p&lt;0.01) after the usage of Kinesio Tape.</p> Victor Romano, Kimberly Smith, Kathryn Hanes-Romano, Jennifer Chambers Copyright (c) 2021 Romano V et al. https://mbmj.org/index.php/ijms/article/view/392 Wed, 10 Feb 2021 00:00:00 +0000 Relationship between Malocclusion and Obesity: A Cross-sectional Study in the Moroccan Population https://mbmj.org/index.php/ijms/article/view/422 <p><strong>Introduction</strong>: Intra-arch dental malocclusions are explained by the disharmony between the arch perimeter and the existing dental capital. The habitable perimeter is the result of the basal and alveolar growth, itself under the dependence of the musculature. The idea of working on the relationship between obesity and malocclusion is to understand whether the effects of mastication and the typology of musculature specific to this category, could have an influence on the dimensions of the arches and therefore on the genesis of malocclusions in children. The aim of this cross-sectional observational study is therefore to evaluate the impact of obesity and overweight on the development of malocclusion in growing age subjects. <br><strong>Materials and Methods:</strong> This study was conducted in 58 children aged 10 to 16 years old who consulted the Rabat Dental Treatment and Consultation Center CCTD-CHIS between January 2018 and December 2018. Excluded from this study were children who had received orthopedic treatment or were undergoing orthodontic treatment, children with system pathology, as well as those with incomplete dentures or proximal caries.&nbsp; The sample was divided into 2 groups according to their Body Mass Index (BMI): G1 normal weight children, G2 overweight or obese children. The variables studied were: dental crowding, overjet and overbite, presence of dysfunction or parafunction and height of the anterior face. The comparison of these variables between the two groups was made by Pearson's Chi-square test for qualitative variables and the non-parametric test (Mann- Whitney's U-test) for quantitative variables. <br><strong>Results</strong>: The results of this study showed that the frequency of dysfunctions and parafunctions, as well as the increase in the lower anterior facial height were greater in the overweight/obese group (57.1%; 62.9% and 60.9% respectively). For endo-buccal parameters, crowding was greater in the overweight/obese group with a median of 2 [0-3] for this group and 1 [0-3] for the normo-weight group. The difference between the two groups for these parameters was not statistically significant. In addition, the results of this study showed that the overjet in the overweight/obese group was slightly reduced (1[o-2]) compared to the norm-weight group (2[1-3]).&nbsp; This difference was statistically significant (p &lt; 0.05).</p> Gbetoho Antah Medard Dohou, Rajae ElHaddaoui, Chanelle Lekesse Apila, Fatima Zaoui, Asmae Bahoum Copyright (c) 2021 Dohou GAM et al. https://mbmj.org/index.php/ijms/article/view/422 Mon, 01 Mar 2021 00:00:00 +0000 Identification of Nasal Carriage of Staphylococcus aureus among Nursing Students during Curricular Clinical Internships: An Observational Study https://mbmj.org/index.php/ijms/article/view/440 <p><em>Staphylococcus aureus</em> is considered one of the most frequently isolated bacteria in the community and in the hospital environment, being associated with several infections. Healthcare professionals represent a group vulnerable to <em>Staphylococcus aureus </em>and MRSA colonization, therefore being potential disseminators of these microorganisms during their care activities. The aim of this study was to evaluate the dynamics of <em>S. aureus </em>and MRSA nasal colonization among nursing students over the four years of university attendance, including pre-clinical exposure and at different moments during clinical rotations. Samples were collected from students from the 1<sup>st</sup>, 2<sup>nd</sup>, 3<sup>rd</sup> and 4<sup>th</sup> year. The study identified 55.9% MSSA positive samples and 31.4% MRSA positive samples from the total studied population. Simultaneous carriage of MRSA and MSSA was observed in students from all years of the nursing degree, but a highest MSSA colonization (61.5%) was linked to a lower MRSA colonization (30.8%). MRSA colonization seems to be dependent on the type of clinical internship, since the group attending internship in emergency rooms and surgery wards presented a significant increase in the amount of MRSA samples. Nursing students should be educated on the risks involved in carrying <em>S. aureus </em>and MRSA and informed about infection control measures.</p> Maria João Coelho, Ricardo Magalhães, Inês Lopes Cardoso, Cristina Pina , Maria Pia Ferraz Copyright (c) 2021 Coelho M et al. https://mbmj.org/index.php/ijms/article/view/440 Tue, 02 Mar 2021 00:00:00 +0000 Over-The-Counter Sales of Antibiotics at Community Pharmacies in Belize: A Cross-Sectional Simulated Client Visit study https://mbmj.org/index.php/ijms/article/view/455 <p><strong>Aim:</strong> In Belize, antibiotics are categorized as prescription-only drugs, and their sales over the counter without a prescription is prohibited. This study assessed the sales and dispensing of antibiotics in community pharmacies without a prescription. <br><strong>Methods:</strong> 36 community pharmacies in 4 districts of Belize were assessed for non-prescription sales of antibiotics using a simulated client method (SCM) approach from September to November 2019. <br><strong>Results:</strong> The majority (19; 52.8%) of the community pharmacies assessed refused to sell antibiotics without a prescription from a physician. Approximately 17 (47.2%) sold and dispensed antibiotics to simulated clients (SCs) without a prescription. Adequate patient counseling was provided by the pharmacists to the SCs. <br><strong>Conclusion: </strong>Some level of lack of compliance with the sales of antibiotics without prescription was observed among community pharmacists in this study. There is a need to reinforce stricter control on the sales and dispensing of antibiotics without prescription in the country of Belize.</p> Danladi C Husaini, Yusuf Abubakar, Lydia Harris-Thurton, David D. Mphuthi Copyright (c) 2021 Husaini DC et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/455 Wed, 03 Mar 2021 00:00:00 +0000 Male Infertility - An Analysis in a Low Resource Setting https://mbmj.org/index.php/ijms/article/view/418 <p><strong><u>Purpose</u></strong> The prevalence of male subfertility is increasing among couples seeking fecundity in recent &nbsp;years. A prospective study was carried out in a gynaecological outpatient , &nbsp;to determine the benefit of a low cost algorithm for diagnosis of adult males with suboptimal semen parameters. <strong>Materials and Methods</strong> Twenty nine males, who had a sperm &nbsp;concentration less than 15 million/ml were considered in the study. The cost of diagnosis was kept low ; not exceeding 150 US dollars. A similar &nbsp;algorithm of investigation was followed for all patients and medical treatment provided as per treatment guidelines .<strong>Results </strong>A confirmed etiology could be determined in 9 patients , while a probable diagnosis was suggested in 17 males. <strong>&nbsp;</strong>Endocrino-metabolic causes were the most important etiological factors in our Indian population . Lifestyle diseases like obesity , insulin resistance were &nbsp;prominently found in the suspected &nbsp;acquired hypogonadotropic hypogonadism group..Medical treatment was provided to 24 males, and 64% showed good improvement in seminal count , after 3 months of therapy. Only&nbsp; selected patients were referred to higher teritiary centres, for specific interventions like sperm retrieval techniques , intracytoplasmic sperm injection of the female partner. <strong>Conclusion</strong> This study &nbsp;proves &nbsp;that male subfertility can be managed in a low resource semiurban centre, with the help of a simple algorithm with ease and proficiency,hence &nbsp;reducing economic burden on these couples. Also, this analysis has helped us &nbsp;to ascertain the relative propensity of&nbsp; etiological factors&nbsp; among &nbsp;adult males with &nbsp;infertility ,in &nbsp;North India in the present &nbsp;time.</p> Deepti Jain, Suvrit Jain Copyright (c) 2021 Jain D & Jain S. https://mbmj.org/index.php/ijms/article/view/418 Thu, 04 Mar 2021 00:00:00 +0000 COVID-19 Lockdown and its Impact on Mental Health in Various Population Groups in Greece: A Cross-Sectional Study https://mbmj.org/index.php/ijms/article/view/447 <p><strong>Introduction: </strong>COVID-19 pandemic and lockdown has brought a serious impact on physical and mental health. <strong>Objective: </strong>The purpose of the present study was to estimate the impact of the first lockdown in Greece, on both quality of life and anxiety levels in different occupational groups. <strong>Methods: </strong>A cross-sectional online survey was conducted from 20th of April to 4th of May 2020. A 24-item anonymous questionnaire was administered to collect basic demographic and socioeconomic data. The 5-item WHO Well-Being Index (WHO-5, 0-100%, cut-off 52%) and the Generalized Anxiety Disorder Assessment (GAD-7) tools were used to assess well-being and anxiety, respectively. Statistical analysis was performed with SPSS for Windows v.24.0 Statistical Package. <strong>Results:&nbsp;</strong>A total of 575 participated in the study, 62.8% females, 48.5% aged between 40 to 59 years. 32.5% were employed in education sector, 32.5% in health sector and 20.3% as season workers in tourism sector. Males showed slightly higher levels of wellbeing (52.1 vs. 47.3, p=0.023) and lower levels of anxiety (7.1 vs. 8.2, p=0.023) compared to females. Factors associated with higher wellbeing and lower anxiety were higher education and income level, optimism, taking less protection measures, and being seasonal worker. Furthermore, participants with comorbidities and symptoms like headache, musculoskeletal pain, as well as feeling depressed or stressed revealed lower wellbeing and higher anxiety scores. <strong>Conclusion: </strong>Our study revealed an overall poor wellbeing and mild to moderate levels of anxiety during the lockdown. Actions should be taken to address and to prevent its serious impact on mental health.</p> Konstantinos Argyropoulos, Konstantinos Krikonis, Eleni Jelastopulu Copyright (c) 2021 Argyropoulos K et al. https://mbmj.org/index.php/ijms/article/view/447 Mon, 08 Mar 2021 00:00:00 +0000 Gestational Diabetes Mellitus: Assessing the Reliability of Risk Factor-Based Screening in a Rural Nigerian Hospital https://mbmj.org/index.php/ijms/article/view/449 <p>Implementation of the 2013WHO diagnostic criteria for Gestational Diabetes Mellitus (GDM), with lower threshold values required for the diagnosis of GDM, may be associated with further rise in the number of missed cases, especially among “low risk women”. This prospective study determined the proportions of women with GDM who were low risk. A hundred and seventeen pregnant women of gestational age 24-32weeks were screened with 50-g glucose challenge Test (GCT) and their GDM risk factor status noted. GCT positive women had 75-gOGTT, using 2013WHO GDM diagnostic criteria. The prevalence of GDM was 7.7% and about 55% of women with GDM had “low risk” status. There was no significant difference in the plasma glucose values of low risk and high risk women. With more than 50% of women with GDM being low risk, risk factor-based screening approach may be very unreliable in screening for GDM.</p> Ayokunle Olumodeji, Idowu Oluwaseyi Adebara, Olumide Emmanuel Adewara, Adebayo Augustine Adeniyi, Sunday Babatunde Awoyinka, Adewummi Bakare, Olabisi Timothy Adeyemo, Olumide Mojisola Ayankunle, Gbadebo Oladimeji Ajani, Segun Murtala Ghazali, Ufuoma Oluwaseyi Olumodeji, Raymond Akujuobi Okere Copyright (c) 2021 Olumodeji A et al. https://mbmj.org/index.php/ijms/article/view/449 Mon, 15 Mar 2021 00:00:00 +0000 Effects of Intermittent Cisplatin Intervention on 6PGD Levels and Tumor Growth and Migration in A549 Lung Cancer Cells https://mbmj.org/index.php/ijms/article/view/442 <p><em><strong>Aim:</strong> To investigate the changes of A549 protein 6PGD expression, tumor growth and migration, NADPH and ROS levels in lung cancer cells after intermittent intervention with DDP. <br></em><em><strong>Methods:</strong> The sensitivity of A549 cells to DDP was detected by cck-8 method, A549 cells were treated by DDP intermitten, 6PGD protein expression was detected by Western blot method, and the ROS level of A549 cells was determined by ROS kit. NADPH levels of A549 cells were determined by NADPH kit. <br><strong>Result:</strong> After DDP intermittent intervention, the expression of 6PGD protein in lung cancer cells A549 was increased, the growth and migration of A549 cells were significantly inhibited, and ROS and NADPH levels were significantly increased. <br><strong>Conclusion:</strong> 6PGD were upregulated in after DDP intermittent intervention and affected the migration ability in lung cancer cells.</em></p> WU Qiang, TANG Lin-dong, WU Yan-hui, LI Qiang, YU Li Copyright (c) 2021 WU Q et al. https://mbmj.org/index.php/ijms/article/view/442 Mon, 15 Mar 2021 00:00:00 +0000 The Combination of Anti-Thymocyte Globulin and Basiliximab for Haploidentical Hematopoietic Stem Cell Transplantation https://mbmj.org/index.php/ijms/article/view/474 <p><strong>Objectives:</strong> Identical hematopoietic stem cell transplantation (haplo-HSCT) is associated with a higher risk of graft rejection when compared to matched sibling donor transplantations. <strong>Methods:</strong> The study included 34 patients who were treated with a novel regimen combining basiliximab, Anti-thymocyte globulin (ATG) and conventional immunosuppressive in the recipients of haplo-HSCT. <strong>Results:</strong> The cumulative incidence of grade II–IV and grade III–IV aGVHD was 38.2% and 11.8%, while the rates of limited and extensive cGVHD were 17.6% and 23.5%, respectively. Laboratory evidence of CMV and EBV reactivation were found in 9 patients (26.5%) and 6 patients (18.8%), respectively. The relapse rate of haplo-HSCT was 14.7% at 1 year; and 1-year OS and DFS were achieved in 58.8% and 55.9% of the patients, respectively. <strong>Conclusions:</strong> The results suggested that basiliximab combined with low-dose ATG could be a promising treatment strategy in haplo-HSCT.</p> Fang Wang, Yun Luo, Ying Zhang, Shifeng Lou, Kang Zhou, Shu Chen, Hanqing Zeng , Yan Shen, Jianchuan Deng Copyright (c) 2021 Wang F et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/474 Wed, 17 Mar 2021 00:00:00 +0000 Long-Term Outcomes in 831 Kidney Transplant Recipients with 20 Years of Graft Function https://mbmj.org/index.php/ijms/article/view/451 <p>An understanding of long-term outcomes for kidney transplant(KTx) recipients who survive with graft function beyond a specific time posttransplant is the first step in creating protocols to optimize care for current and improve outcomes for future recipients. We studied 831KTx recipients-580 living donor(LD); 251 deceased donor(DD)—with graft survival(GS) <u>&gt;</u>20 years.&nbsp; For primary LD recipients, 25-year patient survival(PS) was 83%; 35-year, 59%.&nbsp; Their 25-year death-censored graft survival(DCGS) was 89%; 35-year, 72%.&nbsp;&nbsp; DD recipients had lower PS(<em>P</em>&lt;0.01), DCGS(<em>P</em>&lt;0.01).&nbsp; &nbsp;After 20 years, two major causes of graft loss(GL) were death with function(DwF)(58%, LD; 58%, DD) and interstitial fibrosis and tubular atrophy(IFTA)(22%, LD; 23%, DD).&nbsp; Two major causes of DwF were cancer(31%, LD; 31%, DD) and cardiovascular disease(CVD)(19%, LD;17%, DD).&nbsp; Per multivariate analysis(MVA), risk factors for GL after 20 years in pre–calcineurin inhibitor(CNI) era were human leukocyte antigen(HLA) mismatches <u>&gt;</u>3 antigens, pretransplant type 1 diabetes mellitus(DM1); in CNI era, a history of rejection, female gender.&nbsp; New comorbidities after 20 years were common: CVD(13%, non-DM1;18%, DM1), infections(27%, non-DM1;37%, DM1), 20-29 years posttransplant.&nbsp; Cancer after 20 years included: nonmelanotic skin cancer,22%; solid organ,7%; post-transplant lymphoproliferative disease(PTLD),2%.&nbsp; To improve long-term outcomes, clinical trials on prevention, recognition, and treatment of new comorbidities are needed.</p> Varvara Kirchner, Kristen Gillingham, Oscar Serrano, Srinath Chinnakotla, Ty Dunn, Erik Finger, Raja Kandaswamy, Hassan Ibrahim, Richard Spong, William Payne, Timothy Pruett, David Sutherland, John Najarian, Arthur Matas Copyright (c) 2021 Kirchner V et al. https://mbmj.org/index.php/ijms/article/view/451 Wed, 07 Apr 2021 00:00:00 +0000 Clinical Guideline for Diagnosis and Treatment of Dens Invaginatus https://mbmj.org/index.php/ijms/article/view/448 <p>The invaginated tooth, also called dens invaginatus or dens in dente, is a rare anomaly affecting human dentition, resulting from invagination of enamel organ into the dental papilla.<br />Maxillary lateral incisors are the most commonly affected teeth. The accentuated pit within the DI accumulates debris causing prompt initiation and progression of dental caries with subsequent involvement of the pulp, resulting in periapical pathology. Invagination depth varies from a slight enlargement of the cingulum to an extended invagination into the apex. This anatomic variation means a true clinical challenge because of its complex anatomy. Early diagnosis is then essential to avoid any periodontal complications.<br />This study aims to review: etiopathogenics, classification, elements of the diagnosis and provides guidelines for the management of dens invaginatus cases in clinic that provide hope for teeth that could not be saved before. </p> Najoua ACHABI, Hakima Chhoul, Hind Ramdi Copyright (c) 2021 Achabi N et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/448 Thu, 22 Apr 2021 00:00:00 +0000 Possibilities and Considerations on the Use of ECMO as a Therapeutic Option for Patients with Acute Respiratory Distress Syndrome due to Viral Infections https://mbmj.org/index.php/ijms/article/view/445 <p>Management of acute respiratory distress syndrome due to viral outbreak includes lower tidal volumes, lower inspiratory pressure, prone ventilation and conservative fluid management. Extracorporeal membrane oxygenation (ECMO) has been proposed as rescue therapy in critically ill patients.<br />However, in the absence of larger studies, the role of ECMO in reducing patient mortality rates remains unclear, since studies that reported such effect, both during the current as well as during previous outbreaks, were based on small sample sizes and their results are inconsistent. Furthermore, the use of ECMO might even be contraindicated in the presence of some conditions. Recurring to it has therefore to be discussed by qualified multi-disciplinary teams and based on a case by case strategy.</p> Abderrahmane Bakkali, Hind El Yacoubi, Najib Al Idrissi, Rochde Sayah , Mohamed Laaroussi Copyright (c) 2021 Bakkali et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/445 Mon, 03 May 2021 00:00:00 +0000 Lifestyles and Cognition https://mbmj.org/index.php/ijms/article/view/399 <p>Cognitive decline is a growing medical concern. It includes age-related cognitive decline, mild cognitive impairment, and dementia. Dementia results in considerable dysfunction in life and is associated with an increase in mortality. Since there is no cure at this time, attention is being increasingly directed towards prevention. Lifestyle factors, such as smoking, alcoholism, physical inactivity, poor diet, improper sleep, and loneliness are repeatedly being recognized as modifiable factors that can reduce cognitive decline. This manuscript briefly reviews the lifestyle-cognition relationship.</p> <p>&nbsp;</p> Shashi Agarwal Copyright (c) 2021 Shashi Agarwal https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/399 Mon, 09 Aug 2021 00:00:00 +0000 COVID-19 related Psychotic Disorder: Symptomatology in Infected and Uninfected Patients https://mbmj.org/index.php/ijms/article/view/489 <p><strong>Introduction: </strong>Psychotic disorder has been rarely reported in patients with COVID-19 infection and also in patients affected by the pandemic but who do not have COVID-19 infection. It is unclear if the disorder occurs due to the stress of the pandemic or is due to a cerebral infection of the virus.<br /><strong style="font-size: 0.875rem;">Methods: </strong><span style="font-size: 0.875rem;">on PubMed we searched for all reports of patients who developed a new psychosis during the COVID-19 pandemic to review their symptomatology.<br /></span><strong style="font-size: 0.875rem;">Results:</strong><span style="font-size: 0.875rem;"> Psychotic symptoms were similar in onset, description, duration and severity in patients who had been infected and those who were affected by the pandemic but did not have the infection. In both groups, most patients were young, without previous psychiatric history, had experienced severe external stress due to the pandemic, had an abrupt onset of symptoms, had severe hallucinations and delusions and needed psychiatric hospitalization. The disorder commonly lasted about a week, after which anti-psychotic medications could be stopped.<br /></span><strong style="font-size: 0.875rem;">Conclusion:</strong><span style="font-size: 0.875rem;"> External psychological stress and not cerebral COVID-19 infection is the likely cause of psychotic disorder in both infected and uninfected patients.</span><strong style="font-size: 0.875rem;"> </strong></p> Abhishek Mohan MD, Durjoy Lahiri MD Copyright (c) 2021 Abhishek Mohan MD et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/489 Fri, 24 Sep 2021 00:00:00 +0000 Diagnostic Salivary Gland Imaging - A Review https://mbmj.org/index.php/ijms/article/view/296 <p style="text-align: justify;">The oral and maxillofacial diagnosticians are responsible for the detection, description, differentiation and diagnosis of salivary gland disorders. The algorithm of salivary gland imaging depends on the stage of the clinical disease. For the sake of ease of description, the salivary gland disorders can be broadly divided in to inflammatory, reactive and space-occupying masses. Diagnostic imaging of salivary gland disease may be useful in distinguishing diffuse involvement from focal suppurative involvement, differentiate and identify neoplastic processes from inflammatory disease, delineate ductal morphology, identify sialoliths, identify the effect of salivary gland pathology on adjacent structures, aid in the selection of biopsy sites, etc<sup>1</sup>. This article is aimed at reviewing the different imaging modalities and the current protocol of salivary gland imaging for different clinical situations.</p> Mohamed Abdulcader Riyaz Copyright (c) 2021 Mohamed Abdulcader Riyaz https://mbmj.org/index.php/ijms/article/view/296 Tue, 08 Dec 2020 00:00:00 +0000 The Novel Coronavirus 2019-nCoV: The Effects of Social Distancing and Partial Health Confinement on the Psychological State of Parkinson's Disease Patients https://mbmj.org/index.php/ijms/article/view/289 <p><strong>Background</strong>: The novel coronavirus 2019-nCoV caused by SARS-CoV-2, has caused global, large and major public health issues. During the pandemic, different public health strategies were implemented in order to reduce the spread of this virus. These strategies consisted on increasing the frequency of hand-washing, using personal protection equipment, social distancing and restricting movements cities along with sealing national borders. During this crisis, Health Systems undergo important pressure and remarkable efforts were implemented to provide an efficacious reaction to this emergency. However, the actual global policy of diverting the attention exclusively to the COVID-19 pandemic and overshadowing other clinical conditions may have substantial negative implications. There are particular concerns around the increased vulnerability of patients living with a chronic disease, and this also includes neurological conditions like Parkinson’s disease (PD). <strong>Aims</strong>:&nbsp; This review discusses the different outcomes of social distancing on PD patients and summarizes the circuitry of social behaviour in the context of PD. We consider the possible psychological and behavioral outcomes of quarantine and social isolation as part of national policies to limit the spread of the virus. <strong>Conclusion:</strong> In total, this evidence suggests that the drastic COVID19 pandemic measures could result in affective, cognitive and psychological alterations in these patients. Given this we suggest that patients with PD should be accompanied by their caregivers and encouraged to interact virtually with other family members and friends using different communication technologies. We also recommend healthcare providers to adopt telemedicine for outpatients visits and display educational programs for the patients.</p> Abderrahmane Achbani, Sofiane Ait wahmane, Zakaria Ouhaz, Mohamed Elatiqi, Hasnaa Sine, Youssef Bouchriti, Ahmed Belmouden, Mohamed Nejmeddine Copyright (c) 2021 Achbani A et al. https://mbmj.org/index.php/ijms/article/view/289 Mon, 14 Dec 2020 00:00:00 +0000 The Development of School Oral Health Programs in Qatar https://mbmj.org/index.php/ijms/article/view/308 <p><strong>Background: </strong>The existence of a single school oral health program specifically targeting only 6 and 9 years old, for over 25 years was inadequate to address the oral health problems among the steadily increasing proportion of school children in Qatar. Paucity of remodeling the program to match the growing needs of children in Qatar had resulted in an increased prevalence of dental caries among schoolchildren.<br><strong>Aims:</strong> This paper's primary goal is to present the history of the school oral health program in the State of Qatar. Another overarching goal of this article is to present the development and implementation of a new Asnani (My Teeth) school-based program, which was designed to reach Kindergarten and public primary schools, to reduce the high prevalence of dental caries among school children, and a proposal for National School Oral Health Program plan, that will bring together public and private schools under one umbrella.<br><strong>Recommendation:&nbsp;</strong>With the increasing number of KGs and primary school children experiencing dental caries, a new, integrated, and comprehensive school oral health program should be adopted. The program should assist in reducing dental caries rates among school children in Qatar. Since the treatment of oral diseases is costly, Qatar should focus on oral health promotion and preventive measures that will reduce the need for curative procedures and minimize the financial expenses on dental treatment. In addition, it is necessary to have a department for the National School Oral Health Program to continually monitor public and private schools under one umbrella to reach the ultimate goal of reducing dental caries among school children.</p> Najat AlYafei Copyright (c) 2021 AlYafei N https://mbmj.org/index.php/ijms/article/view/308 Thu, 17 Dec 2020 00:00:00 +0000 What is the Urinary Diversion of Choice after Cystectomy in 2020? https://mbmj.org/index.php/ijms/article/view/320 <p>Urinary diversion is often indicated after radical cystectomy for bladder cancer. It can either be non-continent or continent. Ileal conduit and orthotopic urinary diversions (neobladder) are by far the most commonly used diversions. The choice of the urinary diversion to be carried out is done on several levels in relation to the underlying disease, the state of the patient and the surgeon preference. It is inappropriate to make direct comparisons between enterocystoplasty and ileal conduit because of the differences in the choice of patients for each technique making a prospective randomized trial unlikely.</p> <p>The choice of the technique must be made after clearly informing and explaining explaining to the patient to enable him accept and adapt to his urinary diversion.</p> Youssef Kharbach, Abdelhak Khallouk Copyright (c) 2021 Kharbach Y & Khallouk A https://mbmj.org/index.php/ijms/article/view/320 Thu, 24 Dec 2020 00:00:00 +0000 Fascia Focused Manual Therapy Interventions-proposed treatment for Post-COVID Syndrome https://mbmj.org/index.php/ijms/article/view/339 <p>The novel virus identified as severe acute respiratory syndrome coronavirus [SARS-CoV-2] has resulted in the Coronavirus disease [COVID-19] worldwide pandemic. Confirmed cases of COVID-19 has surpassed 57 million people globally and numbers are exponentially increasing weekly. Significant numbers of recovering patients are reporting long-term, on-going painful soft tissue and respiratory complications. While the total number of deaths directly associated with COVID-19 has exceeded 1million people worldwide, a more accurate figure is estimated to be significantly higher due to limited testing and issues around accurately attributing cause of death. Since its earliest emergence experts have identified the primary source of entry to the body being the nasal and oral cavities via aerosol droplets proliferating across the respiratory tract. Similar Coronaviruses have typically caused mild enteric symptoms including nausea, vomiting, diarrhoea, and respiratory diseases including the common cold. In contrast, COVID-19 has been shown to cause acute fatal pneumonia, systemic out-of-control inflammatory responses, over-production of hyaluronan, cytokines, chemokines and C-reactive protein [CRP], leaky blood vessels, clot-causing antibodies leading to coagulation of blood, and resulting blood clots. Recorded high levels of serum Interleukin 6 [IL-6], Interleukin 8 [IL-8] as well as Tumour necrosis factor alpha [TNF-α] and IL-1β have been observed in COVID-19 patients all contributing to connective tissue damage. The connective tissue fascia has been described as “the universal singularity” due to its ubiquitous nature and has been identified in virtually every organ and structure within the body. Based on available evidence this paper suggests that the Corona virus travels upon the highway that is the fascial singularity whence it permeates cells on a local and global level. A significant number of post-COVID-19 [SARS-CoV-2]&nbsp; patients will experience on-going fascia related pain and a wide range of functional issues. Based on current research this short report proposes that appropriate fascia focused manual and movement therapy interventions will assist patients in recovering from the COVID-19 [SARS-CoV-2]. Fascia focused therapeutic interventions are shown to reduce pain and support a re-establishment of function while providing safe, effective and appropriate non-invasive therapy. A comprehensive search was conducted to systematically review research/reports and professional opinions related to post-COVID-19 syndrome. Surveying appropriate research and reports provided unique detail concerning fascial tissue involvement and underlying disease mechanisms including long-term after-effects of the novel Coronavirus disease [COVID-19].</p> John Sharkey Copyright (c) 2021 Sharkey J https://mbmj.org/index.php/ijms/article/view/339 Wed, 06 Jan 2021 00:00:00 +0000 Review of Coveralls, Gowns, and their Use as Part of Personal Protective Equipment (PPE KIT) for Effective Protection of Healthcare Workers in India in COVID-19 https://mbmj.org/index.php/ijms/article/view/329 <p>Healthcare Workers (HCWs) and public health professionals are playing a pivotal role in containing COVID-19. Personal Protective Equipment (PPEs) are a critical component in the hierarchy of primary infection controls to ‘break the chain of infection’ to protect patients, HCW’s, and public. As SARS-CoV-2 is highly contagious, and vaccine and prophylactics not yet available, understanding correct PPE usage is imperative. This study aims to: understand purpose, use, and quality standards of body-coveralls and gowns and how to use PPE’s for effective protection in COVID 19 in India. Types of PPE’s in healthcare, their purposes, materials used, and properties were reviewed. Gowns and Body-coveralls classification and standards in Europe, USA and India were studied. &nbsp;While current stipulated test standards for coveralls in India are lower, as routine use of reusable gowns made of woven fabrics is more common in India, one could hypothesize that these coveralls provide a higher level of protection. As per current understanding of mode(s) of transmission of SARS-CoV-2 a properly fitted N95 respirator; goggles and splash resistant face shield; gloves; and single-use full body-coverall/gown preferably resistant to Synthetic Blood Penetration under pressure and made of non-woven Laminated SMS (Spunbond-Meltblown-Spunbond)_or Non Laminated SSMMS fabrics are advisable depending upon anticipated level of exposure. HCW’s should educated about transmission risks, correct principles of infection control, functional purpose of PPE’s and must be conscious that PPE’s alone will not protect them. &nbsp;They must follow good practices of how to wear (don) and how to remove (doff) and ensure that they do not inadvertently contaminate their clothing/skin and self-inoculate.</p> Raag Setia, Anita Kamra Verma Copyright (c) 2021 Setia R & Verma AK https://mbmj.org/index.php/ijms/article/view/329 Fri, 08 Jan 2021 00:00:00 +0000 Evaluation of Bone Capital after Orthodontic-Surgical Traction of the Maxillary Impacted Canines: Systematic Review https://mbmj.org/index.php/ijms/article/view/314 <p><strong>Background</strong>: The aim of our study is to evaluate, through a systematic review, the bone capital of the maxillary impacted canines vestibular or palatine trailed compared to their contralateral counterpart.</p> <p><strong>Method</strong>: five databases were consulted: PubMed; PubMed Central, Google Scholar, Cochrane Library, and Ebscohost. The research included published studies from 2010 to 2018, meta-analysis studies, randomized and non-randomized controlled trials, prospective and retrospective studies, case series, control cases.</p> <p><strong>Results</strong>: Among the 299 selected references, only 4 studies met our inclusion criteria. There is no statistically significant difference in alveolar bone loss between the two closed and open techniques for palatal canine traction. Bone loss ranged from 0.03 mm to 0.39 mm compared to the contralateral normal canine. For vestibular traction, bone resorption compared to the normally located canine varies from 0.82 to 0.89 mm.</p> <p><strong>Conclusion</strong>: Canine traction is accompanied by a statistically significant bone loss compared to the contralateral canine. This bone defect is more aggravated when the inclusion is vestibular but remains clinically acceptable.</p> Abdoul Hafizou Rabe, Abdelali Halimi, Fatima Salek, Mohamed Faouzi Azaroual, Asmae Benkaddour, Fatima Zaoui Copyright (c) 2021 Rabe AH et al. https://mbmj.org/index.php/ijms/article/view/314 Fri, 15 Jan 2021 00:00:00 +0000 A Clinical Guide for the Management of Double Teeth https://mbmj.org/index.php/ijms/article/view/346 <p><strong>Introduction:</strong> A double tooth can be a consequence of fusion or gemination and is characterized by a size increasing of the tooth and a morphological modification. This anomaly concerns the anterior teeth and occurs in temporary and permanent dentition. Double teeth causes various problems (aesthetic, occlusal, endodontic, orthodontic, periodontal…). The management of clinical situations involving such abnormalities is often complex. Our aim is to present a reasoned analysis based on a systematic review of therapeutic attitudes used in different clinical situations when the abnormal tooth is located at the anterior maxillary region.&nbsp;<br><strong>Material and Methods:</strong> We carried out electronic research via Pubmed and Sciencedirect to collect case reports published during the 20 recent years (1999-2020). We included 46 articles corresponding to 57 relevant case report that we classified based on Aguilo and coll. Classification (1999).&nbsp;<br><strong>Results</strong>: Partial crown and root section is indicated for type I. Stipping is indicated for type II. The management of type III is compromised by the canal morphology. Extraoral and entraoral hemisection are only indicated for type IV. Coronoplasty is usually unavoidable. Endodontic, orthodontic, or periodontal treatment can be indicated depending on the situation. The extraction is considered as a last resort, the space is restored by autotransplantation of a supernumerary tooth, a prosthetic restoration, or an implant by the end of the craniofacial growth.&nbsp;<br><strong>Conclusion: </strong>The management of double teeth is a therapeutic challenge, every case is different, a multidisciplinary approach is recommended.</p> Wissam El Hazzat, Hicham Benyahia, Fatima Zaoui Copyright (c) 2021 El Hazzat W et al. https://mbmj.org/index.php/ijms/article/view/346 Fri, 15 Jan 2021 00:00:00 +0000 Alternative Techniques for Hepp-Couinaud Roux-Y Hepatico-Jejunostomy: A Brief Review https://mbmj.org/index.php/ijms/article/view/357 <p>To propose alternative techniques in performing Roux-Y Hapatico-Jejunostomy (RYHJ) during treatment of biliary tree diseases. We have retrospectively evaluated PUBMED articles&nbsp; to analyze various modified techniques in RYHJ to research an easy technique to log into biliary tree. Modified RYHJ is a safe, feasible and simple technique to permit an alternative method of anastomosis re-esploration.</p> Danilo Coco, Silvana Leanza Copyright (c) 2021 Coco D & Leanza S https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/357 Fri, 15 Jan 2021 00:00:00 +0000 Digital Models and Orthodontic Diagnosis: What Degree of Reliability? https://mbmj.org/index.php/ijms/article/view/384 <p style="margin: 0cm; margin-bottom: .0001pt;"><strong><span style="color: #0e101a;">Background</span></strong><span style="color: #0e101a;">: Our study aims to evaluate, through a systematic review, the reliability of numerical models compared to conventional models on the main parameters of orthodontic diagnosis<strong>&nbsp;</strong></span></p> <p style="margin: 0cm; margin-bottom: .0001pt;"><strong><span style="color: #0e101a;">Method</span></strong><span style="color: #0e101a;">: four databases were consulted: PubMed; Google Scholar, Cochrane Library, and Ebscohost. The research included published studies since 2010, meta-analysis studies, randomized and non-randomized controlled trials, prospective and retrospective studies.</span></p> <p style="margin: 0cm; margin-bottom: .0001pt;"><strong><span style="color: #0e101a;">Results</span></strong><span style="color: #0e101a;">: Among 3811 selected references, only five studies met our inclusion criteria. In the systematic review, there were statistical differences between the digital models and the plaster models. However, this difference is clinically acceptable. On the other hand, there are some limitations, relative to the types of the severity of the congestion, the elapsed time to digitize, and the numerical means.</span></p> <p style="margin: 0cm; margin-bottom: .0001pt;"><strong><span style="color: #0e101a;">Conclusion</span></strong><span style="color: #0e101a;">: The results of our systematic review have shown that there is no clinically significant difference between the numerical and physical models for the majority of diagnostic parameters.</span></p> Abdoul Hafizou Rabe, Fatima Salek, Intissar El Idrissi, Fatima Zaoui, Hicham Benyahia Copyright (c) 2021 Rabe AH et al. https://mbmj.org/index.php/ijms/article/view/384 Mon, 18 Jan 2021 00:00:00 +0000 Radiotherapy and Management in Maxillofacial Prosthodontic https://mbmj.org/index.php/ijms/article/view/388 <p>The effects of anticancer treatments and cancerous pathology most often lead to tissue defects, deformities and mobility limitations that significantly alter the functions of chewing, swallowing, breathing and communication. These complications are taken care of by different practioners belonging to different specialties.<br>The odontological care of cancer patients must be part of a multidisciplinary collaboration, indeed, it aims to plan and optimize the conduct of care in relation with the progress of anti-cancer treatment (Radiotherapy, chemotherapy, etc.).<br>The objective of this work is to focus on the areas of collaboration between the specialist in maxillofacial prosthosontic and the radiotherapist / oncologist and to propose a liaison sheet between these two practioners to facilitate communication and achieve a symbiosis.<br>This liaison sheet constitutes a tool streamlining the multidisciplinary consultation between the odontologist and the radiotherapist / oncologist and consequently facilitating the care of these patients.</p> Wijdane El Hawari, Hasnae Rokhssi, Mohamed Azhari, Nadia Merzouk, Oussama Bentahar Copyright (c) 2021 El Hawari W et al. https://mbmj.org/index.php/ijms/article/view/388 Mon, 18 Jan 2021 00:00:00 +0000 Radiotherapy and Management in Maxillofacial Prosthodontic https://mbmj.org/index.php/ijms/article/view/387 <p>The prevalence of head and neck cancers continues to increase throughout the world, the modality of their management mainly includes surgery, radiotherapy (RTH), and chemotherapy and antiresorptive treatment.<br>The complications of radiotherapy imperatively require concerted management and rigorous monitoring. Indeed, collaboration with the multidisciplinary team is essential and guarantees therapeutic success.<br>The management of patients during and after these anticancer treatments by the specialist in maxillofacial prosthesis essentially comprises the treatment of early and late complications of radiotherapy, oral care and finally prosthetic rehabilitation depending on the case.<br>The objective of this work is to describe the protocols and recommendations for the management of patients during and after radiotherapy and to highlight the role of the specialist in maxillofacial prosthodontics in this management.</p> Wijdane El Hawari, Hasnae Rokhssi, Mohamed Azhari, Nadia Merzouk, Oussama Bentahar Copyright (c) 2021 El Hawari W https://mbmj.org/index.php/ijms/article/view/387 Mon, 18 Jan 2021 00:00:00 +0000 Radiotherapy and Management in Maxillofacial Prosthodontic https://mbmj.org/index.php/ijms/article/view/386 <p>Anti-cancer treatments (surgery, radiotherapy and chemotherapy) lead to numerous sequelae and side effects, unpleasant or even disabling in the oral cavity. In the absence of appropriate dental care, the consequences can be highly detrimental.<br>The side effects of radiotherapy, the loss of substances following often associated surgical interventions and the unfavorable context of these patients require rational planning and consultation approved by the various practionners.<br>The management of patients before, during and after these anticancer treatments by the specialist in maxillofacial prosthesis is important, in fact the objectives outlined to be achieved in terms of the management of PMF are: restoration of orofacial functions, participation in the proper conduct of anticancer treatment, palliation of its complications and psychological support for these patients.<br>The aim of this article is to review the various complications of radiotherapy, as well as the protocols and recommendations for the management of patients before radiotherapy and to highlight the role of the specialist in maxillofacial prosthodontics in this management.</p> Wijdane El Hawari, Hasnae Rokhssi, Mohamed Azhari, Nadia Merzouk, Oussama Bentahar Copyright (c) 2021 El Hawari W https://mbmj.org/index.php/ijms/article/view/386 Mon, 18 Jan 2021 00:00:00 +0000 Dietary Approach for Post-COVID Treatment of Olfactory Loss https://mbmj.org/index.php/ijms/article/view/439 <p>The spread of severe acute respiratory syndrome coronavirus [SARS-CoV-2] has consequently led to the global COVID-19 pandemic. Many patients, whether hospitalized or not, have reported a variety of complications that persist after recovery. The admission for COVID-19 has been associated with anosmia and hyposmia, the inability or decreased ability to smell. Deficiencies in the ability to smell tend to recover within weeks. However, a significant number of cases have been reported in which smell distortions last for several months. Experimental research has identified inflammation as a factor disrupting olfactory neurons. Precisely, local inflammation through cytokine release in sustentacular and horizontal basal cells interferes with the function of olfactory neurons. Further studies have reported that these local inflammatory events are not responsive to common corticoid treatments. Therefore, in order to mediate the recovery of olfaction in COVID-19 patients after viral recovery, this study evaluates vitamin C, vitamin D, vitamin E, and omega-3 polyunsaturated fatty acids to develop a prospective dietary approach with anti-inflammatory properties to reduce the local inflammation of sustentacular and horizontal basal cells.</p> Shreyashish Roy-Chowdhury, Arvindsai Satishkumar, Syed Hamza Ahmed, Austin Mardon Copyright (c) 2021 Roy-Chowdhury S et al. https://mbmj.org/index.php/ijms/article/view/439 Mon, 15 Feb 2021 00:00:00 +0000 Non-Syndrome Case of Multiple Erupted Supernumerary Teeth and Wisdom Tooth Anodontia https://mbmj.org/index.php/ijms/article/view/409 <p>Supernumerary teeth can be detected during a routine clinical or radiographic examination. They are&nbsp;defined as any tooth or tooth substances that are excess of the usual configuration of twenty&nbsp;deciduous and thirty-two permanent teeth (1). Supernumerary teeth can cause several complications. It depends on the location or stage of their formation, such as: preventing or delaying the eruption of associated permanent teeth, crowding or malocclusion The main aim of orthodontic treatment of&nbsp;supernumerary teeth is to restore adequate dental aesthetics and functions. After the clinical,&nbsp;radiographic and tomographic diagnosis, the orthodontic treatment of supernumerary teeth will&nbsp;depend on several factors. Such as; the location, proximity to vital anatomical structures, space&nbsp;availability in the arch, shape and the amount of supporting periodontal tissue. Reports in Western&nbsp;Region in Saudi Arabia showed that the range of the prevalence of supernumerary teeth was&nbsp;0.1–3.8% of the population. The current finding, however, was 0.3%, a finding that is not in concert&nbsp;with what was reported by Fardi et al. in which the prevalence of supernumerary teeth was 1.8%.<br>This case reported a unilateral four premolars erupted to occlusion in the right mandibular arch for&nbsp;non-syndrome patient.</p> Nawaf Alzaben, Husein Alomer, Yousef Tashkandi Copyright (c) 2021 Alzaben N et al. https://mbmj.org/index.php/ijms/article/view/409 Wed, 24 Feb 2021 00:00:00 +0000 The Effectiveness of Maxillary Expansion in Wearers of Cleft Lip and Palate https://mbmj.org/index.php/ijms/article/view/432 <p><strong>Introduction: </strong>Cleft Lip and Palate (CLAP) is one of the most frequent craniofacial anomalies. The management of patients with CLAP requires several repair procedures for the soft palate, the primary and secondary bony palate, the alveolar ridge, the lips and the nose. These patients often present with a maxillary transverse deficit responsible for maxillary endognathy which must be corrected for a harmonious development of the maxillomandibular complex. The objective of our work was to evaluate the efficacy of slow, rapid and surgical maxillary expansion in patients with sequelae of CLAP following a systematic review protocol. <br><strong>Materials and methods: </strong>Four databases were searched: PubMed / MEDLINE, ScienceDirect, Cochrane Library and EBSCOhost, using the keywords present in the MeSH according to the equation [Maxillary expansion] AND [Cleft lip and palate]. The selection of articles included all studies published since January 2010 and for which the full text is available, such as meta-analyzes, randomized and non-randomized controlled clinical trials, case-control studies and prospective and retrospective studies. <br><strong>Results: </strong>Among 1107 references only 8 studies met our inclusion criteria. Following analysis of these, we concluded that there is no significant difference between rapid maxillary expansion and slow maxillary expansion in patients with unilateral CLAP, the expansion observed on the side of the cleft is larger than that seen on the healthy side. Surgically assisted expansion is much more reserved for subjects at the end of growth, having unilateral or bilateral CLAP and presenting anterior or posterior lateral crossbones. The results of our systematic review also showed that maxillary expansion in patients with CLAP results in substantial dentoalveolar compensation. <br><strong>Conclusion: </strong>The efficacy of maxillary expansion in patients with sequelae of CLAP is real and alone in some cases allows the restoration of a normal transverse dimension; sometimes in combination with maxillary protraction to correct the anteroposterior deficit.</p> Richard Togbedji Dahoue, Abdelali Halimi, Médard Antah Gbètoho Dohou, Rajae Elhaddaoui, Fatima Zaoui Copyright (c) 2021 Dahoue RT et al. https://mbmj.org/index.php/ijms/article/view/432 Mon, 01 Mar 2021 00:00:00 +0000 The biological and Mechanical Behavior of the Standard Implant under Removable Partial Dentures: Systematic Review https://mbmj.org/index.php/ijms/article/view/436 <p><strong>Background: </strong>The implant-supported removable partial denture appears to be an interesting alternative for cases where the implant-supported fixed prosthesis is contraindicated whether it is for medical, local, or financial reasons. The objective of this systematic review is to evaluate the biological and mechanical behavior of the implant under a removable partial denture.<br><strong>Methods:</strong> A literature search was conducted on the following databases: Pubmed [Medline], Science Direct, and Cochrane Library. Research was limited to publications in English and French during the period from 01/1/2007 to 27/03/2020.<br><strong>Results: </strong>Of the 334 citations initially identified, 22 articles met our inclusion criteria, assessing the implant survival rate, patient satisfaction, and the occurrence of implant and prosthetic complications. As well as the evaluation of the stress distribution on the three support surfaces of this prosthesis. Finally, the evaluation of implant localization. The results showed a high rate of implant survival, the occurrence of some prosthetic complications. Stable and acceptable bone resorption over the long term. Better stress distribution at the implant and the bone.<br><strong>Conclusion: </strong>The biological and mechanical behavior of the implant under this type of prosthesis appears to be viable in the short, medium, and long term. Although this association between implantology and partial prosthesis seems promising, additional studies are needed to spread this practice still reserved for some specific cases.</p> Ghita Kadri, Loubna Bahije , Saloua Berrada Copyright (c) 2021 Kadri G et al. https://mbmj.org/index.php/ijms/article/view/436 Mon, 01 Mar 2021 00:00:00 +0000 Interleukin 6 as a Predictive Biomarker for Atrial Fibrillation after Coronary Bypass Grafting: A Systematic Review https://mbmj.org/index.php/ijms/article/view/454 <p>Atrial fibrillation (AF) progresses after coronary bypass grafting in 11–40% of patients. Plasma biomarkers such as interleukin 6 (IL-6) can assess the risk of AF development. We performed a systematic review using as sources:&nbsp; PubMed, LILACS, and Cochrane Library databases were investigated using Boolean operators and MeSH terms (Medical Subject Headings Terms) “Atrial Fibrillation AND Interleukin AND Biomarkers”. &nbsp;As the following eligibility criteria: observational studies, studies with coronary artery bypass grafting with plasma levels of IL-6 recorded after screening, 11 articles were selected. Three studies met the inclusion and exclusion criteria. Results: IL-6 levels on AF group - Ishida et al. reported the plasma levels of IL-6 during the post-operative period as 360 ± 143 pg/mL, while Pretorius et al. reported it to be 380.6 ± 151.1 pg/mL. Lastly, Ziabakhsh-Tabari et al. reported a post-operative plasma IL-6 level of 38.2 ± 32 pg/mL. It is considered that new studies about the object are necessary, and these studies should be more standardized. Preferably, it would be important for the daily measurement of IL-6 and its correlation with AF development for statistical analysis to set the best time for sample collection and cut-off value.</p> Roberta Gomes da Mata, MS, Ana Luisa Adorno de Lima, MS, Prof. Antonio da Silva Menezes Jr , PhD Copyright (c) 2021 da Mata RG et al. https://mbmj.org/index.php/ijms/article/view/454 Mon, 08 Mar 2021 00:00:00 +0000 Breathing Reeducation after Surgical Maxillary Expansion: A Systematic Review https://mbmj.org/index.php/ijms/article/view/425 <p><strong>Background:</strong> Surgically assisted maxillary expansion has been used for the treatment of transverse maxillary deficiency in adult patients. The aim of this study is to evaluate, through a systematic review, the effect of this therapy on the dimensions of the aeropharyngeal dimensions and on the improvement of nasal ventilation. <strong>Materiel and method:</strong> 5 databases have been explored from 2010 (Pubmed, Scopus, Embase, Cochrane and Web of Science) using keywords expansion AND airway AND volum. After evaluating title, abstract and full text of articles found from databases, only 11 matching the inclusion criteria were included in the systematic review. <strong>Results: </strong>All the studies have shown that, in addition to its action on the maxillary bone, surgically-assisted maxillary expansion induces also an enlargement of the nasal floor and a reduction in airflow resistance, which promotes an improvement in nasal breathing. <strong>Conclusion:</strong> this surgical approach may lead to a modification in upper airway’s dimension and improvement of nasal ventilation.</p> Houda Neani, Youssef Oualalou, Ahlam Assali, Fatima Zaoui Copyright (c) 2021 Neani H et al. https://mbmj.org/index.php/ijms/article/view/425 Mon, 29 Mar 2021 00:00:00 +0000 Transcription Factor NF-κβ and Molecules Derived from its Activation in Age-Related Macular Degeneration https://mbmj.org/index.php/ijms/article/view/393 <p>Activation of the nuclear factor kappa β (NF-κβ) is related to many inflammatory diseases, including age-related macular degeneration (AMD). The imbalance in the redox state, which happens mainly in senescence, associated with several peculiar characteristics of the macular region, has led to studies of this molecule for AMD therapeutic interventions.&nbsp; Findings report the involvement of NF-κβ both in the triggering as well as in the worsening condition of AMD. The present article correlates AMD oxidant and inflammatory genesis with the action of the nuclear factor kappa β. Besides its mechanism of action, this study also analyzes the main inflammatory cytokines and adhesion molecules that may be activated by NF-κβ and are closely related to AMD.</p> Rogil Jose De Almeida Torres, Rogerio Torres, Andrea Luchini, Ana Lucia Ferreira Copyright (c) 2021 Torres RJA et al. https://mbmj.org/index.php/ijms/article/view/393 Tue, 30 Mar 2021 00:00:00 +0000 An MRI of the Olfactory Tract in a Case of Post-COVID-19 Persistent Anosmia https://mbmj.org/index.php/ijms/article/view/406 <p>Anosmia is a prevalent and pathognomonic symptom in patients with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), often accompanied by changes of taste or dysgeusia. It is also one of the symptoms that lasts the most even after the recovery. The studies that examine the migration path and timing of SARS-CoV-2 are needed in order to determinate the ideal timing for realizing an MRI so as to possibly find an abnormal signal on the olfactory bulb.&nbsp;</p> Amal Hajjij, Najwa Benslima, Jehanne Aasfara, Hatim Bensouda , Mohammed Mahi, Fouad Benariba Copyright (c) 2021 Hajjij A & Benslima N https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/406 Mon, 03 May 2021 00:00:00 +0000 The Contribution of Lumbar Puncture in Neonatal Infections - About 206 cases https://mbmj.org/index.php/ijms/article/view/583 <p><strong>Background:</strong> Neonatal meningitis is a serious infection, no clinico-biological score has been established to accurately identify neonates at high risk of developing neonatal meningitis.<br /><strong>Objective:</strong> The aim of this work is to clarify the place of lumbar puncture in neonatal infections and to identify the predictive factors of meningeal localization in case of neonatal infection.<br /><strong>Materials and methods:</strong> This is a prospective study of 861 observations of newborns hospitalized in the pediatric department of Mohammed V Hospital, CHU of Tangier, during a 14-month period from 1January 2019 to 29 February 2020. Among these patients the diagnosis of neonatal infection (NNI) was retained in 473 cases. Initial lumbar puncture was performed in 206 cases (43%). We included neonates aged 0 to 28 days, suspected of NNI, who had a lumbar puncture. Neonates treated as carriers of neonatal infection without sufficient anamnestic and clinical evidence and with an inconclusive or unperformed biological workup were excluded from the study.<br /><strong>Results:</strong> During the study period, 861 newborns were hospitalized and the diagnosis of neonatal infection was retained in 473 cases, a rate of 55%, and the initial lumbar puncture was performed in 206 cases (43%). 61 newborns were diagnosed with neonatal meningitis, with fever in 76% of cases, 85% with convulsions, hypotonia and/or refusal to suckle in 63% of cases, and CRP &gt;25mg/l in 67% of newborns.<br /><strong>Conclusion:</strong> Lumbar puncture is the only diagnostic means of meningitis. Indeed, the indication of this procedure should not be systematic, but it should be dictated by the careful and simultaneous analysis of the anamnestic, clinical and biological criteria evocative of the infection and its meningeal localization in order to diagnose meningitis early and treat it correctly. The need to establish scores combining these different parameters, in order to accurately identify newborns at high risk of developing neonatal meningitis</p> Ettoini Kaoutar, Yousra El boussaadni, Abdallah Oulmaati Copyright (c) 2021 Ettoini Kaoutar, Yousra El boussaadni, Abdallah Oulmaati https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/583 Mon, 25 Oct 2021 00:00:00 +0000 An erosive lesion of the buccal mucosa revealing an early squamous cell carcinoma https://mbmj.org/index.php/ijms/article/view/435 <p>Oral squamous cell carcinoma is the most common epithelial malignant neoplasm affecting the oral cavity. It accounts for 90% of all oral cancers. It usually arises from a pre-existing potentially malignant lesion, and occasionally <em>de novo</em>. The use of tobacco, betel quid and alcohol are well known risk factors for oral squamous cell carcinoma.</p> <p>Early detection is an important criterion for achieving high cure rate. Occasionally, OSCC may be misdiagnosed because of its variable and innocuous clinical appearance.</p> <p>We report the case of an early presentation of Oral squamous cell carcinoma in a patient aged 70 without preexisting risk factors, with a painful and soft erosion in the buccal mucosa for 2 months. The lesion resembled other benign lesions, but biopsy was mandatory and revealed an early squamous cell carcinoma.</p> Laila Benjelloun, Saliha Chbicheb Copyright (c) 2021 Laila Benjelloun, Saliha Chbicheb https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/435 Mon, 09 Aug 2021 00:00:00 +0000 Determination of the Occlusal Plane in Complete Denture: About the Paterson Technic https://mbmj.org/index.php/ijms/article/view/488 <p>The rehabilitation by complete removable denture is commonly used for edentulous patients. The respect of operating procedures represents the main condition for therapeutic success.<br /><span style="font-size: 0.875rem;">Among these procedures, the determination and the orientation of occlusal plane remain an important step to respect minutely<br /></span><span style="font-size: 0.875rem;">Indeed, it is one of the most stages for obtaining an optimal smile esthetic, a facial harmony and improve the oral functions.<br /></span><span style="font-size: 0.875rem;">Various technics were reported by many authors: anatomical, radiographic, and physiologic methods such as piezography and Paterson technic.<br /></span><span style="font-size: 0.875rem;">This later consists on the determination of the individualized occlusal plane according to the registration of physiological movements.<br /></span><span style="font-size: 0.875rem;">In this context, we will describe Paterson method via a case report and discuss its feasibility, clinical effectiveness as well as its advantages compared to others technics.</span></p> Jihane El Aoud, Wijdane El Hawari , Nadia Merzouk, Faiza Benfdil Copyright (c) 2021 Jihane El Aoud et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/488 Sat, 02 Oct 2021 00:00:00 +0000 Cantilever Resin Bonded Bridges…What evolution? About case reports https://mbmj.org/index.php/ijms/article/view/529 <p>Resin bonded bridge technique was first introduced in 1963 by Rochette. It was the first type of non-invasive fixed dental prosthesis because the abutment tooth didn’t undergo any prior preparation. As early as 1996, Hussey and Linden studied cantilever resin bonded bridges and showed that there was no significant difference in the survival rates of a conventional bridge and cantilever resin bonded bridges. The main indications for a resin bonded bridge in children are post-traumatic edentulousness, during the early detection of agenesis and pre-implant temporization situations. Resin bonded bridges are also recommended in adults when the implant context is unfavourable or contraindicated (periodontal diseases and / or anatomical and prosthetic obstacles). Cantilever resin bonded bridge has many advantages compared to the traditional bridge: simpler and faster to make, more economical for the patient, easier hygiene and absence of partial detachment that can lead to secondary caries lesion.<br />The preparation criteria will be adapted to the clinical situation, which will take into account the patient's age, the extent of edentulousness, the extent of occlusal loads and dental mobility. Thus, when the joint is subject to excessive stress, retention devices will complete the preparation. With the continuous development of materials as well as new minimally invasive treatment modalities, the alternative solution of the bonded bridge in the anterior region now corresponds to the realization of an all-ceramic zirconia cantilever bridge with a single wing.</p> Soraya El Yaagoubi, Morchad Bouabid, Amal El Yamani Copyright (c) 2021 Soraya El Yaagoubi, Morchad Bouabid, Amal El Yamani https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/529 Mon, 11 Oct 2021 00:00:00 +0000 Facial Erysipelas: A Case Report https://mbmj.org/index.php/ijms/article/view/315 <p>Erysipelas is a superficial cutaneous process that is usually restricted to the dermis, but with prominent lymphatic involvement commonly caused by streptococci. We present a patient who was admitted for swelling and erythema of his left cheek. We diagnosed facial erysipelas, the curative treatment was based on the prescription of effective antibiotic therapy against streptococci and bacteria producing β-lactamase (staphylococci). Removal of the remaining teeth was scheduled during medical treatment. At a 4-month follow-up after dental removal, there has been no recurrence of erysipelas.<br>Through a clinical case of facial erysipelas, this work allows illustrating the specificities of this pathology.</p> Dr Lamiae Hallab, Pr Bouchra Taleb Copyright (c) 2021 Hallab L & Taleb B https://mbmj.org/index.php/ijms/article/view/315 Mon, 21 Dec 2020 00:00:00 +0000 Management of an angulated maxillary central incisor impacted: A case report https://mbmj.org/index.php/ijms/article/view/313 <p>The inclusion of the maxillary incisors, although rare, poses even more difficulty to the practitioner who diagnoses it. This difficulty is increased in front of an angulated incisor in a labial position with the “policeman's sign”, the prognosis of orthodontic therapy being reserved.<br>This article aims to describe a clinical case of retention of two maxillary central incisors with radicular angulation and in a vestibular position in an 11-year-old adolescent, referred in the Rabat dental consultation and treatment center. clinically, we can note the absence of the two maxillary central incisors on the dental arch, confirmed by the X-ray with the presence of obstacles on the path of the incisors which are in a very high position with angulated roots. The challenge was to put on the arch of the teeth and especially the aesthetic challenge. The satisfactory result obtained is only the result of the motivation of the patient as well as the dexterity of the practitioner. Despite the current treatment, we are comforted in our choice to treat. it is obvious for us that the only absolute contraindication to traction in the case of an impacted incisor remains dilaceration</p> Gbetoho Antah Medard Dohou, Togbedji Richard Dahoue, Ali Halimi, Fatima Zaoui Copyright (c) 2021 Dohou M et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/313 Mon, 21 Dec 2020 00:00:00 +0000 Critically Ill Patients with Variable Heart Failure in Severe COVID-19 Disease: A Case Series https://mbmj.org/index.php/ijms/article/view/336 <p>COVID-19 disease, while primarily a respiratory disease, has proven itself a multi-system disorder with profound cardiovascular sequelae. In patients with SARS-CoV-2 infection, effective early diagnosis and management of concomitant cardiovascular manifestations of the disease are key to favorable outcomes. Here we present a case series of three patients with varied cardiovascular presentations of severe COVID-19 illness: cardiogenic shock from Takotsubo cardiomyopathy, arrhythmia in a patient with suspected hydroxychloroquine-associated cardiomyopathy, and right-sided heart failure with obstructive shock in the setting of massive pulmonary embolism. Through our experience, we aim to provide a better understanding of the unique spectrum of the cardiovascular effects of severe COVID-19 disease to guide management of the critically ill.</p> Joanne Michelle Gomez, Mary Potkonjak, Maria Isabel Planek, Prutha Lavani, Karolina Marinescu, Tisha Suboc Copyright (c) 2021 Gomez JMD et al. https://mbmj.org/index.php/ijms/article/view/336 Sun, 03 Jan 2021 00:00:00 +0000 Congenital Glaucoma: Thinking about Sturge-Weber-Krabbe Syndrome https://mbmj.org/index.php/ijms/article/view/337 <p>Congenital glaucoma is called "primary" if it is due to an isolated anomaly of the development of the iridocorneal angle. It is secondary when associated with other lesions, ocular or systemic.&nbsp;<br>Phacomotoses present 50% to 70% of the etiologies of childhood Glaucoma, including Sturge Weber Krabbe syndrome (SWKS) [2].&nbsp; We report the case of an infant admitted for a clinical picture made of angioma with seizures associated with glaucoma evoking an SSWK to remind practitioners of the clinical, radiological and especially evolutionary aspects of this disease entity.<br>Childhood Glaucoma is a rare disease that occurs from birth to adolescence. This usually results in vision loss. About 8% of cases of blindness have been attributed to this disease in the pediatric population [2].&nbsp;&nbsp;</p> <p>&nbsp;</p> Kaoutar Ettoini, Yousra El boussaadani, Abdallah Oulmaati, Nabila Elouafi Copyright (c) 2021 Ettoini K et al. https://mbmj.org/index.php/ijms/article/view/337 Wed, 06 Jan 2021 00:00:00 +0000 Idiopathic Harlequin Syndrome in a Young Women during Physical Exercise: A Case report and literature review https://mbmj.org/index.php/ijms/article/view/317 <p>The Harlequin syndrome is a rare and benign disorder of the sympathetic nerves that is mostly idiopathic. It is characterized by an erythema associated with an intense sweating of one side of the face, and a pallor and anhidrosis of the other side. A complete workup to rule out secondary organic causes should be done properly. The medical or surgical options are only required if the patient is in demand of treatment.&nbsp; Psychological and social impacts of this condition should be considered while consulting patients for treatment options. We report a case of a 24 years old female patient who presented this syndrome during exercise and heat stress. She improved considerably after botulinum toxin injections.</p> Amal Hajjij, Madiha El Jazouli, Othmane Haddani, Fouad Benariba Copyright (c) 2021 Hajjij A et al. https://mbmj.org/index.php/ijms/article/view/317 Fri, 08 Jan 2021 00:00:00 +0000 Odontogenic Keratocyst Mimicking a Radicular Cyst https://mbmj.org/index.php/ijms/article/view/356 <p>The odontogenic keratocyst (OKC) is a benign intraosseous cyst of the odontogenic origin, characterized by an aggressive behavior with a relatively high recurrence rate.OKC is mostly presented at the 2nd and 3rd decades and predominantly affect males. It affects mandible more than maxilla and is frequently found at the angle of mandible. OKC can clinically and radiographically mimic other benign and less aggressive lesions. It is therefore important to differentiate them from other cysts and tumors, for a proper treatment and reduction of recurrences.<br>We report the case of a 19-year-old woman who presented with a swelling in left mandible. The clinicaland radiographicfeatures were in favor of a radicular cyst.Histological examination, however, contradicted this diagnosis, indicating a case of OKC.</p> Soukaina Essaket, Laila Benjelloun, Saliha Chbicheb Copyright (c) 2021 Essaket S et al. https://mbmj.org/index.php/ijms/article/view/356 Fri, 15 Jan 2021 00:00:00 +0000 Bilateral Adrenal Lymphoma: A Diagnostic Challenge https://mbmj.org/index.php/ijms/article/view/354 <p>Bilateral primary adrenal lymphoma is rare with no specific clinical or imaging features. We report herein the case of a 44-year-old man presenting with massive bilateral adrenal tumors associated with normal adrenal function. Computed tomography findings were nonspecific. Because pheochromocytoma was ruled out and the patient had a normal coagulation test, we performed an ultrasound-guided adrenal biopsy for diagnostic purposes. Pathology confirmed adrenal non-Hodgkin's lymphoma. By reporting our case, we aimed to&nbsp;propose a practical approach for this rare entity and to show that there are still situations in which biopsy is necessary to make a diagnosis.</p> Youssef Kharbach, Siham Rachidi Alaoui, Zakaria Bakkali Issaoui, Abdelhak Khallouk Copyright (c) 2021 Kharbach Y et al. https://mbmj.org/index.php/ijms/article/view/354 Fri, 15 Jan 2021 00:00:00 +0000 Pre-prosthetic Orthodontic Implant for an Aesthetic Rehabilitation : A Case Report https://mbmj.org/index.php/ijms/article/view/276 <p>A combination of dental problems such as missing teeth, proclination of teeth and occlusal problems cannot be satisfactorily treated by prosthodontic approach alone. The rehabilitation of patients requiring an esthetic smile demands the collaboration of multiple dental specialists. the need for orthodontic tooth movement prior to restorative treatment is necessary for some patients, in order to optimize both esthetic and functional aspects of dental treatment.<br>The present case report achieved successful implant based oral rehabilitation in a patient with&nbsp; absence of the right maxillary central incisor utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.</p> Afaf Houb-dine, Anissa Regragui, Asmaa Benkaddour, Asmaa Bahoum, Fatima Zaoui Copyright (c) 2021 Houb-dine A et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/276 Sat, 28 Nov 2020 00:00:00 +0000 Orthodontic Treatment by Compensation of a Skeletal Class III Associated with Mandibular Laterognathy: Aesthetic Challenge and Therapeutic Occlusion https://mbmj.org/index.php/ijms/article/view/373 <p><strong>Introduction: </strong>This case report describes compensatory orthodontic treatment in a young patient aged 13 years. She presented with a class III skeletal malocclusion associated with mandibular laterognathy. The patient's main reason for consultation was the anterior cross bite and the aesthetics of her smile.<br><strong>Materials and Methods:&nbsp;</strong>The chosen treatment was therefore an orthodontic camouflage with the extraction of the first mandibular premolars and the second maxillary premolars, in order to catch a correct anterior articular and restore a good occlusal relationship, however, the mandibular laterognathy was camouflaged by means of dental compensations and also by correcting the deviation of the incisors medians through a class III mechanics with good anchorage management.<br><strong>Results:&nbsp;</strong>After 24 months of treatment, an ideal overjet and overbite associated with a Class I canine and molar relationship, was obtained, associated with a perfect coincidence of the interincisor medians.<br><strong>Conclusion:&nbsp;</strong>Class III skeletal cases can often be treated either by orthodontic camouflage or surgery. In our case study, the treatment adopted was orthodontic camouflage with extractions. The results of the treatment were satisfactory and the occlusal objectives were achieved. The final harmonious smile pleased the patient and improved her self-esteem and quality of life.</p> Laila Elhajoubi, Intissar Elidrissi, Asmae Bahoum, Fatima Zaoui, Mohammed Faouzi Azaroual Copyright (c) 2021 Elhajoubi L et al. https://mbmj.org/index.php/ijms/article/view/373 Tue, 02 Feb 2021 00:00:00 +0000 Palatal-root Resection in Endodontic–Periodontal Combined Lesions - A Case Report https://mbmj.org/index.php/ijms/article/view/411 <p>Endodontic-periodontal combined lesion is a clinical dilemma because establishing a differential diagnosis and predicting a prognosis are difficult. A correct diagnosis is sometimes difficult; an accurate knowledge of the etiologic factors is essential for adequate choice of treatment. The management of endodontic-periodontal combined lesion demands both endodontic and periodontal therapy. Root resection therapy is one treatment option for preserving multirooted tooth with furcation involvement. This case report reviews root resective therapy and the concomitant endodontic management as a treatment option for an endo-periodontal lesion in periodontitis patients in maxillary molar. The role of root resection and treatment strategy are also discussed based on a review of the endodontic and periodontal literature.</p> Houda El Ayachi, Samir Er-raji, Jalila Semmach, Driss Benazza Copyright (c) 2021 El Ayachi H et al. https://mbmj.org/index.php/ijms/article/view/411 Thu, 11 Feb 2021 00:00:00 +0000 Anaesthesia for Reconstruction Surgery Post Mandibulectomy in a Patient with a Predicted Difficult Airway: A Case Report https://mbmj.org/index.php/ijms/article/view/426 <p><strong>Introduction: </strong>Mandibular surgeries, edentulous mandible, use of dentures, and aging all predispose to residual mandibular ridge resorption and thinning. The edentulous state of the mandible makes the tongue occlude the upper airway. All these, contribute to difficulty in managing the airway. An adequate pre-operative review helped classify this index patient as high risk for difficult airway and adequate steps were taken to facilitate optimal airway management.<br><strong>Case report</strong>: We present a 53 years old woman with mandibular deformity, anterior neck mass and inadequate mouth opening who has had a segmental mandibulectomy and a soft tissue closure of reconstruction plate. She was scheduled for mandibular reconstruction.<br>She was successfully intubated using a size 4.5 Intubating Laryngeal Mask Airway (ILMA) through which a size 6.0 ID classic endotracheal tube was introduced for ventilation. A gum elastic bougie was then inserted through the endotracheal tube, both the ILMA and classic endotracheal tube were withdrawn. An armored tube size 6.5 ID was then rail roaded.<br><strong>Conclusion</strong>: The successful anaesthetic management of this difficult airway patient was facilitated by a thorough pre-anaesthetic plan, concise and skilled anaesthetic management strategy with a well organized team work.</p> Omolola Adunni Fagbohun, Ibifuro Dennar, Olugbusi Sope, Oresanwo Theressa Copyright (c) 2021 Fagbohun O et al. https://mbmj.org/index.php/ijms/article/view/426 Wed, 24 Feb 2021 00:00:00 +0000 Control of Metastatic Tumor Growth in a Patient with Sporadic Metastatic Malignant Peripheral Nerve Sheath Tumor (sMPNST) Using the Hope Protocol, an Alternative Treatment Regimen for Cancer https://mbmj.org/index.php/ijms/article/view/453 <p>Metastatic sporadic malignant peripheral nerve sheath tumor (sMPNST) is associated with only 17% five-year survival rate using standard chemotherapy and there are no 10-year survival reports with the exception of a case report wherein a patient with metastatic sMPNST is still alive with no active disease and on no further cancer therapy, &gt;12 years from DeltaRex-G treatment initiation. In this case report, we describe an interim alternative treatment regimen designed and used by a patient with metastatic sMPNST, while awaiting the return, GMP bioproduction, and QC certification of DeltaRex-G as a potential treatment option. We report on the successful control of metastatic tumor growth over a one-year treatment period using the Hope Protocol consisting of artemisinin, curcumin, cannabis oil, disulfiram, fenbendazole, mebendazole, albendazole, atorvastatin, doxycycline, vitamin C, vitamin E, a plant-based diet, sans refined sugar, yoga, acupuncture, meditation, exercise and hot sauna, and we discuss their biochemical mechanisms of action.</p> Erlinda Gordon, Jonathan Dang, Nicole L. Angel, Don A. Brigham, Lance Ostendorf, Omid Jafari, Sant P. Chawla, Frederick L. Hall Copyright (c) 2021 Gordon EM et al. https://mbmj.org/index.php/ijms/article/view/453 Wed, 03 Mar 2021 00:00:00 +0000 The Place of Dentofacial Orthopaedics in the Treatment Planning of Facial Clefts: About Two Clinical Cases https://mbmj.org/index.php/ijms/article/view/471 <p>Facial clefts are considered as predominant malformations of the oro-facial sphere due to their frequency, aesthetic and functional repercussions. The overall prevalence of cleft palates is estimated at 1 per 700 births in the general population, with 77% of isolated cases, 16% associated with another malformative pathology, and 7% associated with a known syndrome. They can disrupt soft tissues (upper lip, nasal threshold, nasal wing, palate veil), hard tissues (alveolar arch, dental germs, palate), or both.<br>They constitute a congenital dysmorphosis for which the therapeutic management extends from birth to the end of adolescence. Orthodontic care has evolved considerably in recent years, mainly due to the synergy of the different specialities involved in the care of these children by the multidisciplinary team.<br>These cleft lips and palates have a multifactorial and complex etiology requiring a multidisciplinary approach. Orthodontic treatment has a strategic place in this treatment and involves temporary, mixed, and permanent dentition.<br>The aim of this article is to review the place of dentofacial orthopaedics in the therapeutic calendar of facial cleft management.</p> Intissar El Idrissi, Fatima Salek, Youssef Ouedraogo, Fatima Zaoui, Abdelali Halimi, Loubna Bahije Copyright (c) 2021 El Idrissi I et al. https://mbmj.org/index.php/ijms/article/view/471 Mon, 08 Mar 2021 00:00:00 +0000 Severe Neuroleptic Induced Ischemic Colitis: A Case Report https://mbmj.org/index.php/ijms/article/view/462 <p>Ischemic colitis (IC) is a rare adverse effect of antipsychotic medications and is most commonly associated with the phenothiazine class of neuroleptics. Different cases reported in patients without other obvious risk factors led to the link between taking neuroleptics and acute ischemic colitis. The severe form is acute necrotizing colitis. This entity is characterized by sudden onset of abdominal pain and bloody diarrhea, progressing rapidly to produce severe illness with general peritonitis and shock.<br>We report a case of a 26 years old Moroccan man, treated for four years for chronic psychosis, admitted to the emergency for abdominal pain and diarrhea. Clinical examination showed a conscious patient, tachycardia at 120 beats/min, febrile to 38.5 ° C, with generalized abdominal defense. Laboratory tests revealed: GB 33400, CRP 290 mg/l, abdominal tomography revealed colonic distension. The patient was prepared and admitted to the operating room. During the intervention, a colonoscopy was performed and shown ulcerated lesions with a purplish background without interval healthy mucosa. A subtotal colectomy with ileostomy and sigmoidostomy were performed. The histological examination of the surgical specimen showed superficial and extended ulcerations without interval healthy mucosa. Thus, no factors for IC were detected by appropriate workup other than the long-time use of neuroleptics. The restoration of continuity by ileorectal anastomosis was achieved two months later with a good clinical outcome, and the patient was recommended for psychiatry to reevaluate his antipsychotic regimen given the association with IC.<br>Our case supports that neuroleptics can promote IC in patients under antipsychotic medications. It should alert physicians who prescribe neuroleptics and colorectal surgeons to the possibility of intestinal ischemia. Although the clinical presentation is non-specific, abdominal pain and distension should be headed, and endoscopy carried out. A better knowledge of this condition should promote earlier diagnosis and improve management.</p> Younes Aggouri; Anas Ahallat, Aymane Jbilou, Yassine Mohamed , Badr Tarif, Said Ait laalim Copyright (c) 2021 Aggouri Y et al. https://mbmj.org/index.php/ijms/article/view/462 Mon, 08 Mar 2021 00:00:00 +0000 A Minimally Invasive Treatment of Dental Fluorosis: A Case Report https://mbmj.org/index.php/ijms/article/view/450 <p>L'action carioprotectrice du fluor par voie topique est reconnue depuis plus d’une cinquantaine d’année. Ce dernier est devenu aujourd’hui, l'un des piliers de la prévention de la maladie carieuse. Toutefois, l’ingestion excessive de cet oligo-élément durant les premières années de la formation des dents peut entrainer l’apparition d’une fluorose dentaire. Il s’agit d’une anomalie de structure acquise pré-éruptive caractérisée par un aspect polymorphe variant en fonction de la sévérité d’atteinte. Elle peut engendrer, dans certains cas, en fonction de son impact sur la couleur et l'aspect de surface de l'émail dentaire, un préjudice esthétique et fonctionnel majeur. Pour pallier cette problématique, la dentisterie moderne propose un vaste champ thérapeutique allant de l’éclaircissement aux restaurations prothétiques. L’objectif principal est d’adopter une thérapeutique adaptée selon chaque situation tout en étant le moins invasif possible. C’est dans cette optique que ce travail se propose de présenter la gestion thérapeutique d’une fluorose dentaire chez une patiente âgée de 14 ans. Le traitement a consisté en la combinaison de deux méthodes :&nbsp; la micro-abrasion et l’éclaircissement externe ambulatoire ce qui a permis d’obtenir un résultat très satisfaisant pour la patiente, tout en respectant le principe d’économie tissulaire.</p> Merieme Lferde, Sarah Tabbai, Houda El Khammal, Hakima Chhoul Copyright (c) 2021 Lferde M et al. https://mbmj.org/index.php/ijms/article/view/450 Mon, 22 Mar 2021 00:00:00 +0000 Assessement of the Nasal Shape after Orthognathic Maxillary Surgery https://mbmj.org/index.php/ijms/article/view/552 <p><strong>Background</strong>: Orthodontic and surgical modifications have been shown to have aesthetic effects on the shape or position of the nose. <strong>Aim:</strong> To evaluate nasal changes using cephalometric assessment after orthognathic surgery. The PIDAQ was cross-culturally adapted into Malay version by forward- and backward-translation processes, followed by psychometric validation.<br /><strong>Methods</strong>: A cross-sectional study was carried out involving 20 Moroccan orthognathic patients from January to March 2019. Their mean age was 22.40 (+/-6.98 years). The amplitude of the surgical movements of all patients was measured using measurements on profile teleradiographs and photos of faces taken before and after surgery. The statistical analysis of cephalometric data before and after surgery was performed using the Wilcoxon test. The significance level was p≤0.05.<br /><strong>Results:</strong> The results revealed a significant reduction in the angular values of SNA (°) (p&lt;0.001), GoGn/SN (°) (p=0.038), Occ/Sn (°) (p=0.007) and AoBo (mm) (p=0.025). No statistically significant differences were noted for specific cephalometric variables before and after surgery as for facial photographs. All the values of the specific measurements before and after were significant except Prn - SN. <br /><strong>Conclusion: </strong>The width of the base of the nasal wing and the displacement and the amount of rotation of the nasal tip increased considerably in most patients while the X-axis to Prn distance decreased.</p> Farid Bourzgui, Samir Diouny, Idriss Tougui, Ayoub El Omari, Zineb Serhier , Mohamed Bennani Othmani Copyright (c) 2021 Farid Bourzgui, Samir DIOUNY, Idriss TOUGUI, Ayoub EL OMARI, Zineb SERHIER , Mohamed BENNANI Othmani https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/552 Mon, 11 Oct 2021 00:00:00 +0000 Is Hip Spica an Obsolete Method for Paediatric Femur Fractures ? - A Retrospective Analysis of 58 Patients https://mbmj.org/index.php/ijms/article/view/309 <p><strong>Background</strong>- Diaphyseal femur fracture in paediatric age group are common in orthopaedics with treatment options varying from conservative methods such as hip spica to operative measures such as nailing/plating. We analyzed results of patients treated conservatively in a hip spica cast. <strong>Material and Methods- </strong>58 patients, upto 5 years of age, with shaft femur fracture managed by hip spica cast were retrospectively analysed in terms of healing clinically and radiologically and complications noted, if any. <strong>Results- </strong>Fracture healed satisfactorily in all patients. Mean age of patients affected was 3.8 years. Males were more affected and road side accident was most common etiology. Mean hospital stay was 3.4 days. Most common complication was skin breakage (27.58%) followed by cast soiling or breakage (13.79%) while shortening was seen in 3 patients (5.1%) and angulation in 2 patients (3.44%). <strong>Conclusion- </strong>Despite newer and safer implants, hip spica remains safe and cost effective method for treatment of femur fracture in children.</p> Umesh Yadav, Ajay Sheoran, Himanshu Bansal, Ashish Devgan, Amit Dahiya, Mittal Ankit, Mayank Dutta, Ajay Singh Copyright (c) 2021 Umesh Yadav et al. https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/309 Mon, 07 Dec 2020 00:00:00 +0000 Contribution to the Assessment of the Quality of the Pre-Analytical Phase of Medical Biology Tests at the Ibn Sina University Hospital in Rabat https://mbmj.org/index.php/ijms/article/view/375 <p>The study of the nonconformities (NC) literatures in medical biology report that between 60-85% of laboratory errors are produced during the pre-analytical phase, which are often external and escapes the biologist's control. The objective of our study was to identify the factors at the origin of non-conformities during this phase at the University Hospital of Rabat. A mixed analytical descriptive study realized between August 2019 and August 2020 based on a non-compliance&nbsp;form, a self-questionnaire, an observation grid, focus groups and semi-structured interviews. We also set up the Deming wheel PDCA as well as the work tools (BRAINSTORMIN, 5M, ISHIKAWA). Our results show that 22 % of the prescriptions of biologic tests are drafted by nurses and not doctors this in the absence of an updated list of biological exams. The samples are taken at 88,1% by unqualified personnel and 95 % without any guide or manual.&nbsp; For the traceability aspect, the name of the sampler is never placed on the sheet of examination, age, sex of the patient; time and nature of the sample are often not mentioned in the label vials of samples.&nbsp; Transportation is made by pneumatic cylinder system and sometimes by unqualified staff in absence of procedures for packaging and transportation equipment without traceability. The reception of samples is carried out by untrained staff on the error management of the pre-analytical phase. They result at first from a major defect of coordination between the laboratory and the services, then by the lack of continuing education and the weak competence of the staff involved in this process and finally compounded by the lack of manual sampling, procedures for packaging, transport, reception and triage.</p> Abdelhak Jnah Copyright (c) 2021 JNAH A https://mbmj.org/index.php/ijms/article/view/375 Fri, 15 Jan 2021 00:00:00 +0000 Sociodemographic and Clinical Profile of Suicide Attempts in Adults: Case of a Moroccan Hospital https://mbmj.org/index.php/ijms/article/view/382 <p><strong>Objective: </strong>Over the past decade, and despite the increasing awareness of suicide attempts among adults in Morocco, there was no complete system of statistics. As a result, the socio-demographic profile of reported adult suicide attempts varied in some studies. The purpose of this study was to provide the socio-demographic and clinical profile of suicide attempts in adults in a Moroccan hospital.<br><strong>Methods</strong>: A retrospective study of a descriptive type carried out in Psychiatric University Hospital Arrazi-Salé during one and a half year (January 2016 to April 2017). The information was collected using a pre-established questionnaire based on medical records. The data entry and statistical evaluation were performed by the SPSS software (20.0).<br><strong>Results: </strong>A total of 62 patients were recruited, 32 women and 30 men who met the eligibility criteria. The profile of the suicidal attempters who must be kept in the hospital to prevent a suicidal recidivism is a young adult between the ages of 25 and 40, male, with psychiatric disorder: mood disorder, schizophrenia, anxiety disorder, borderline personality disorder, histrionic or psychopathic personality, alcohol or other psychoactive substance dependence, familial and emotional connectedness, material deprivation with previous suicide attempt that demonstrates the possibility of acting out because as we known that the risk of recidivism increases with the number of previous attempts.<br><strong>Conclusion:</strong> The development of repeated epidemiological surveys makes it possible to better understand the prevalence of suicide attempts in Morocco and to implement suicide prevention programs.</p> Fouad Laboudi, Ghizlane Slimani, Nabil Tachfouti, Abderrazzak Ouanass Copyright (c) 2021 Laboudi F https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/382 Fri, 22 Jan 2021 00:00:00 +0000 Investigation of Hepatitis B virus DNA among HBsAg positive patients in Kabul, Afghanistan https://mbmj.org/index.php/ijms/article/view/400 <p><strong>Background</strong>: Hepatitis B virus (HBV) infections are one of the world's health problems that annually kill about 500,000 to 1,200,000 people. Investigation of HBV DNA in the person infected with HBV is a definitive indicator of activation and replication of HBV.<strong>Objectives</strong>: The aim of this study is to investigate the DNA of HBV in HBsAg positive patients and to study the risk factors for virus activation. <strong>Methods</strong>: This study was conducted on 106 HBsAg positive patients from January 2020 to July 2020 in Kabul. After informed consent, 3 to 5 milliliters of blood was collected for the HBV-DNA testing using the Real-time PCR method.<strong>Result</strong>: Out of 106 HbsAg positive patients, 74 (69.8%) were males and 32 (30.2%) females. The patients were aged between 11 and 65 years. Hepatitis B virus DNA was positive in 58 (54.7%) of the samples, 41 (70.7%) were male and 17 (29.3%) were female. The viral DNA load was in the range of 9.85 x 10<sup>2 </sup>to 9.3 x 10<sup>8</sup> copies/ ml. Most of the patients were aged between 20 and 30 years. <strong>Conclusion</strong>: From 106 HbsAg positive patients, 23(39.7%) were in the age group of 20 – 30 years, and males were more infected than females. The majority of the patients were married and had an informal job with education below grade 12. No specific differences were found in the availability of HBV DNA between patients who received hepatitis B treatment before and those who did not.</p> <p>&nbsp;</p> <p>&nbsp;</p> Hashmatullah Yousufi, Ahmad Zia Noori, Hamidullah Rasekh Copyright (c) 2021 Yousufi H et al. https://mbmj.org/index.php/ijms/article/view/400 Wed, 17 Feb 2021 00:00:00 +0000 The effects of age on weight loss after sleeve gastrectomy https://mbmj.org/index.php/ijms/article/view/433 <p><strong>Introduction</strong>: Laparoscopic sleeve gastrectomy is a primary treatment of obesity among older adults and its satisfactory outcomes would be the main reason behind the popularity of this procedure. We aim to evaluate the impact of age on excess weight loss in adult morbidly obese subjects older than 60 years old following LSG.<br><strong>Methods</strong>: In this retrospective survey, 3,072 subjects were included in the study that underwent LSG in Erfan Hospital. Screening follow-up period was 12 months. The level of statistical significance was set at P &lt; 0.05. We hired comorbid conditions to avoid bias results including hypertension, diabetes mellitus and dyslipidemia. <br><strong>Results</strong>: Of 3072 patients, 1879 cases were females (61.2%) and 1193 subjects were males (38.8 %). Mean %EBMIL of the group 12 months after surgery was 78.9 %. In younger than 60 years old group, mean %EBMIL 12 months postoperative 83 % and patients&nbsp; over 60 years demonstrated mean %EBMIL 74.9 %. There was an obvious difference among age groups in presence of diabetes mellitus and hypertension in the older group which was more frequent. <br><strong>Conclusion</strong>: To sum up, laparoscopic sleeve gastrectomy is safe procedure for older groups. Albeit, %EBMIL was significantly lower in older group compared to younger subjects, but resolution in comorbidities was satisfactory.</p> Taha Anbara Copyright (c) 2021 Anbara T https://mbmj.org/index.php/ijms/article/view/433 Mon, 01 Mar 2021 00:00:00 +0000 Description of Nasoalveolar Molding Process in Neonatal Period of Unilateral Cleft Lip and Palate: A Step by Step https://mbmj.org/index.php/ijms/article/view/376 <p><strong>Statement of problem.</strong> Cleft Lip and Palate (CLP) are common congenital defects of the present day. They result from a failure of facial bud sticking during embryological phenomena. Their therapeutics based on multi-disciplinary care to restore as much as possible the aesthetic and functional prejudices generated by these anomalies. <br><strong>Purpose.</strong> Through this work, we will illustrate, through a clinical case supported at the Consultation and Dental Treatment Center of Rabat, clinical and laboratory stages of realization of Nasoalveolar Molding (NAM). <br>Material and methods. We describe original techniques used in our service for manufacturing of NAM fireworks and we define recommendations after insertion and follow-up procedures.<br><strong>Result.</strong> Place of NAM in management of these anomalies has increasingly recommended, given limitations of surgery alone to ensure satisfactory aesthetic results. Several fixed or removable appliances has used, in order to reposition gaps in cleft and / or to reshape affected bordering tissues. <br><strong>Conclusion.</strong> Despite the controversies surrounding this therapy, it remains highly recommended and scientifically based.</p> Mohamed Azhari, Wijdane El Hawari, Hasnae Rokhssi, Nadia Merzouk, Oussama Bentahar Copyright (c) 2021 El Hawari W https://creativecommons.org/licenses/by/4.0 https://mbmj.org/index.php/ijms/article/view/376 Thu, 14 Jan 2021 00:00:00 +0000 Neuroleptiques Causing a Giant Abdominal Mass https://mbmj.org/index.php/ijms/article/view/402 Younes Aggouri; Aymane Jbilou, Said Ait laalim Copyright (c) 2021 Aggouri Y et al. https://mbmj.org/index.php/ijms/article/view/402 Mon, 08 Mar 2021 00:00:00 +0000