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New Approach for Analysing the Discrepancy of Pretherapeutic Tc-99m and Intra-therapeutic I-131 uptake in Scintigraphies of Thyroid Autonomies using a Parametric 3D Analysis Program

Published on: 2nd January, 2017

OCLC Number/Unique Identifier: 7286427358

Introduction: Radioiodine therapy is a standard procedure in thyroid autonomy treatment. Discrepancies in the visual comparisons of the scintigraphies prepared for this purpose using Tc-99m-O4- and I-131 have been known for years. In this study a new method is used to calculate and perform a quantitative comparison of both uptakes using subtraction analysis and 3D imaging. The results and their causes are discussed together with practice-relevant conclusions for better clinical results. Material and Methods: The new method was used in 38 patients with thyroid autonomies for the subtraction analysis of standardized pretherapeutic and intratherapeutic scintigraphies. The parametric distribution of activity was calculated absolutely and as a percentage and displayed three-dimensionally. These results were compared with the visual assessment of the different scintigraphies by the experts. Inclusion criteria were pretherapeutic and intratherapeutic hyperthyroidism without medication affecting the thyroid. The time difference between acquiring the scintigraphies was 28 days maximum. Results: Activity distribution was visually discrepant in 39.5% of cases. 60.5% displayed comparable uptake. The calculated values showed reversed results after applying the new method. The results using our method show a higher rate of calculated discrepancies compared with visual analysis. Conclusion: Accurate functional imaging of the thyroid is next to further aspects very important in establishing the diagnosis and deciding about the therapy activity for thyroid treatment. In combination with clinical symptoms and laboratory values, Tc-99m-O4 - scintigram can be used for an orientated, preliminary assessment of functional disorders of the thyroid. But because of the higher rate of found discrepancies, the solely use of Tc-99m-O4 - scintigram is not always capable for exact and reliable diagnosis. The known reason for this is most probably due to the different biokinetics of both radiopharmaceuticals, which can be imaged more sensitively with this method. Consequently, a scintigram should be performed in the pretherapeutic radioiodine uptake test. Despite higher costs and radiation exposure, alternatively, pretherapeutic use of other diagnostic iodine isotopes like I-123 or -124 should be discussed, because they could overcome the limitation of the different biokinetics. Following this approach the preliminary assessment using Tc-99m-O4 - scintigraphy can be precised and double checked to improve diagnostic confi dence and treatment results for a better outcome of the patients.  
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Time to Terminate LNT: Radiation Regulators Should Adopt LT

Published on: 26th June, 2017

OCLC Number/Unique Identifier: 7286353862

The linear no-threshold hypothesis (LNT)-the basis of radiation regulatory policy-extrapolates from observed high-dose harm to assumed low-dose harm, entailing that all ionizing radiation is harmful, by denying any biological response to damage and asserting cumulative lifetime harm, regardless of dose or dose rate. All aspects of LNT are demonstrably false. There are evolved biological responses that repair or remove radiogenic damage from low doses and dose rates, thereby averting acute harm and precluding the alleged cumulative damage. LNT and its offspring, the “as low as reasonably achievable” principle, do not err on the side of caution; neither is truly conservative. The public needs protection from radiophobia, rather than from low-dose radiation exposure. Neither radiation regulations nor medical practice should be based on LNT, but rather, at least as a first step, on a linear (down to a) threshold (LT) model.
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Immediate postplacental insertion of intrauterine contraceptive device (copper 375) and its complications in term of expulsion, infection and perforation

Published on: 27th December, 2018

OCLC Number/Unique Identifier: 7964701690

Objective: To determine the complications (infection, perforation and expulsion rate) of immediate postplacental insertion of intrauterine contraceptive device (Multiload Copper375) in postnatal patients. Methods: A case series study was conducted between October 28, 2014 to April 30, 2018 in obstetrics and gynaecology department, Civil Hospital Karachi,-+ Informed consent was taken. Intrauterine contraceptive device (Multiload) was inserted immediately within 10 min after delivery of placenta. These women were observed to determine outcome (infection, perforation and expulsion) at the time of discharge and 6 weeks postpartum. Absence of all these were taken as satisfactory outcome. Results: A total of 435 women were included in this study. 165 (38%) were delivered through cesarean section and 270 (62%) were delivered through vaginally. There were 36 (8.3%) cases of infection. The cumulative rate of expulsion and perforation at the end of sixth week of post insertion was 39 (9%) and 0% respectively and 360 (82.8%) had satisfactory outcome. Post-placental placements during cesarean delivery are associated with lower expulsion rates than post-placental vaginal insertions without increasing rates of postoperative complications like perforation, slightly increase infection rate following vaginal delivery. Conclusions: Immediate postpartum insertion of IUCD is an effective, safe and easily reversible method of contraception. Rates of the complications (Infection, expulsion and perforation) are remarkably low.
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Synthesis, Radioiodination and Biological distribution of 5-(5-(tributylstannyl) benzofuran-2-yl) pyridin-2-amine as an amyloid imaging agent

Published on: 26th December, 2017

OCLC Number/Unique Identifier: 7317576309

In this work an efficient method developed for the synthesis of 125I-benzofuran-2-yl) pyridin-2-amine (125IBPA), followed by radioiodination with 125I by using Chloramine-T at pH 8. The reaction proceeds within 10 min at room temperature (20-25°C). The radiochemical yield determined by Thin-Layer Chromatography (TLC) using hexane:ethyl acetate (1:6 v/v) and the purity analyzed by high-performance liquid chromatography using a reversed-phase RP18column and acetonitrile:0.1 M ammonium bicarbonate (pH 7.5) (1:1) as the mobile phase at a flow rate of 1 ml×min−1. The radiochemical yield using aH2O2 oxidant found equal to 96.5% with a radiochemical purity of 125I-BPA of over 96.5%. The biodistribution data in normal mice indicated a high initial uptake of 6.54±0.10 (% ID/g±SD) in the brain within 30 min post-injection. These results promote a further the use of 125I-BPA as a novel agent for brain imaging.
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Role of Carcinoma Associated Fibroblasts in Anoikis Resistance in Oral Squamous Cell Carcinoma –need of the hour

Published on: 30th January, 2017

OCLC Number/Unique Identifier: 7317601183

Anoikis resistance (AR) is a favorable attribute exhibited by cancer cells for metastasis. Carcinoma associated Fibroblasts (CAFs) plays a crucial role in AR in various cancers. It was proved in array of studies in different cancers that there was definite interrelationship between CAFs and AR. But its role in OSCC is ambiguous. It is the need of the time to reveal the correlation of CAF and oral squamous cell carcinoma (OSCC) in relation with anoikis. Molecular pathways which affects the AR via CAFs in various cancers has been highlighted in this communication. Divulging the importance of CAF in cancer will aid in designing customized novel chemoprevention therapy and thus will help in enhancing the prognosis of patient in OSCC.
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Evaluation of ImageJ for Relative Bone Density Measurement and Clinical Application

Published on: 15th December, 2016

OCLC Number/Unique Identifier: 7286423139

The main method for evaluation of healing processes of the jaws in oral and maxillofacial surgery are radiological diagnostics. Quantitative description is possible by measuring the relative bone density, which puts the mean grey value of a certain area in relation to the surrounding bone tissue. In this research the intra- and interindividual variability is determined for this method and a standard operation procedure is elaborated. Therefore ten panoramic radiographs of typical surgical indications in oral a maxillofacial surgery were analyzed by three different members of the workgroup, five times each. The measurements were analyzed with descriptive and comparative statistical methods. The mean coefficient of variation was 2.972% ± 2.361%. The measurements of defect regions were more consistent (2.252% ± 1.928%) than the measurements of surrounding bone (3.691% ± 2.626%). The analysis of variance did not show a statistically significant influence of the different raters to the measurements (ANOVA, Pr>F = 0.9462). Following the standard operation procedure this method seems to be an easy, cheap and close to practice way to visualize healing process of the jaws. Especially in the mandibula, but also in the maxilla with special reconsideration of the sinus-region, it seems to be suitable.
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Comparative Study of Enophthalmos Treatment with Titanium Mesh Combined with Absorbable Implant vs. Costochondral Graft for Large Orbital Defects in Floor Fractures

Published on: 23rd March, 2017

OCLC Number/Unique Identifier: 7286350491

Introduction: Several treatment options are available for the optimal treatment for orbital fractures, depending on aesthetic and functional results after orbital wall reconstruction. The objective of this study is to compare the effect and safety of large orbital floor fractures with titanium mesh combined with poly-L-lactic acid/polyglycolic acid copolymer implants (Lactosorb®) vs. autologous costochondral graft. A wide range of permanent and biodegradable materials have been used successfully for orbital floor reconstruction, however they present with disadvantages for reconstruction of large defects, even if combined. Patients and Methods: A retrospective cohort study of patients from Estado de México, México, with access to ISSEMYM health care service, presenting with orbital floor fracture treated at Department of Plastic & Reconstructive Surgery/Maxillofacial Surgery at ISSEMYM Medical Center Toluca between January 2007 and July 2010. Age, sex, etiology, clinical findings, fracture pattern, and treatment modality (Titanium mesh with absorbable implant vs. costochondral graft) were considered. Predictor and outcome variables as complications, inpatient, trauma- surgery interval, surgical time and donor site pain are considered. Results: Follow up of 21 patients (12 weeks) 17 male, 4 female, ages 22-63 was made. Enophthalmos, main objective of this study, was identified with statistical significance presenting 0% (n=0) post-op Group B patients and 30% (n=3) for Group A (p=0.049). Statistical significance was found referring to inpatient days between two groups being less for costochondral reconstruction patients (p=0.02). No pain in patients undergoing alloplastic surgery. An interesting result was that donor area analogue pain scale for costochondral graft was 2.9/10. Conclusion: Surgical outcome and complications where evaluated comparing different materials for orbital floor reconstruction. Costochondral graft is a suitable choice when orbital reconstruction is indicated.
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Enamel demineralization with resin modified gic and conventional composite resin - a comparative in vivo study

Published on: 31st July, 2017

OCLC Number/Unique Identifier: 7286352515

Background & Objectives: Fluoride releasing bonding agents can help the orthodontist to minimize enamel demineralization independent of patient cooperation. This in vivo study was conducted to evaluate the efficacy of resin modified glass ionomer cement (RMGIC) on reducing enamel demineralization around orthodontic brackets and confirm the superior caries-preventive effect of RMGIC by assessing the mutans streptococci (S. mutans) in plaque samples in vitro. Methods: 60 subjects (aged 14-20 years) scheduled to have premolar extractions as part of the orthodontic treatment plan were selected and randomly divided into 2 groups of 30 each (group 1: the brackets were bonded on the teeth using light cure composite resin and group 2: the brackets were bonded using RMGIC). Plaque scores (modification of plaque index by Silness and Loe) were recorded and plaque samples were collected before bonding, one week and one month after bonding. S.mutans colonies were recorded from the plaque samples inoculated on MSB agar plates, incubated under 95% N2 and 5% CO2 for 48 hours at 370C in a CO2 jar. After 1 month, the right maxillary and mandibular first premolars were debonded, extracted and depth of enamel demineralization area was estimated using polarized light microscope. Results: After statistical analysis, a significantly higher mean depth of demineralized lesions was noticed in group 1 as compared to group 2. A significant difference between occlusal and gingival depth was seen only in group 2, thus illustrating a wedge effect. In group 1, a statistically significant increase in the mean colony forming units (CFU) of S.mutans has been noticed at different time intervals whereas in group2, a significant increase was observed only at 1month. Unlike at 1 month, a statistically significant difference in mean CFU between group 1 and group 2 has been observed at 1 week (P<0.05). Conclusions: Enamel lesions adjacent to the bracket base on teeth bonded with the RMGIC were smaller than those on teeth bonded with a composite resin. The high “burst effect” of fluoride release for the first few days of RMGIC after bonding is confirmed by statistically significant reduction in CFU counts of S. mutans in plaque.
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Osteogenic Accelerated OrthodonticsTM for treatment of a Skeletal Class II patient with moderate crowding

Published on: 18th September, 2017

OCLC Number/Unique Identifier: 7286353388

Introduction: A 17 years old male patient was treated at the University orthodontic department. He had the chief complaint of unaesthetic appearance of his teeth, mostly for anterior crowding. The pretreatment records showed a Class II skeletal relation, moderate upper and lower anterior crowding, 0.5mm of overbite and 2mm of overjet. Materials and Methods: It was suggested Osteogenic Accelerated Orthodontics (OAOTM), the treatment option was very attractive to the patient although it required a surgical procedure and a more expensive type of treatment. Results: The overall treatment time was 6 months, facial balance was improved and the final occlusal relationships from the functional and aesthetics perspective were good. Conclusion: OAOTM is a good alternative to reduce extractions rate as it increases the scope of tooth movement and strengthen the periodontal tissues thru bone grafting, although these claims require more scientific data to be validated.
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Open bite malocclusion: An overview

Published on: 12th January, 2018

OCLC Number/Unique Identifier: 7379416963

The term open bite is referred as no contact between anterior or posterior teeth. The complexity of open bite is attributed to a combination of skeletal, dental and habitual factors. Etiology of open bite can be attributed to genetics, anatomic and environmental factors. However, the tendency toward relapse after conventional or surgical orthodontic treatment has been indicated. Therefore, open bite is considered one of the most challenging dentofacial deformities to treat. The aim of this article is to emphasize that early etiological diagnosis, dentofacial morphology and classification are essential to the successful outcome of the technical intervention. Failure of tongue posture adaptation subsequent to orthodontic and/or surgical treatment might be the primary reason for relapse of open bite. Prolonged retention with fixed or removable retainers is advisable and necessary in most cases of open bite treatment. The treatment of open bite remains a tough challenge to the clinician; careful diagnosis and timely intervention with proper treatment modalities and appliance selection will improve the treatment outcomes and long-term stability. 
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Utilization of post abortal contraceptive use and associated factors among women who came for abortion service at Debre Berhan Hospital, Debre Berhan, Ethiopia March 2019: Institution based cross sectional study

Published on: 20th June, 2019

OCLC Number/Unique Identifier: 8193601650

Background: Post abortion family planning (PAFP) is the initiation and use of family planning methods immediately after, and within 48 hours of an abortion, before fertility returns. In most women fertility returns on average about two weeks after an abortion; however, ovulation can occur as early as 11 days post-abortion. Objective: To assess utilization of post abortal contraceptive use and associated factors among women who came for abortion service at Debre Berhan Referral Hospital, Debre Berhan, Ethiopia March 2019. Methodology: Institutional based cross sectional study design was conducted using hospital data obtained from Gynecology ward in Debre Berhan Referral Hospital, Debre Berhan, Ethiopia, from March 1 -10, 2019. A systematic random sampling technique was used from the abortion register log book. Data was cleaned manually, coded and entered into Epi-data version 3.1 then exported to and analyzed by SPSS version 21 software. Multivariate analysis with AOR, 95% CI and p-value< 0.05 were used to identify variables which have significant association. Result: The finding of the current study showed that among 371 study subjects 170(45.8%) utilized post abortal family planning. There was a significant association between utility of post abortal family planning and post abortion family planning counseling [AOR: 19.245, 95% CI: (10.199, 36.313), p-value= 0.001] and women who were primiparous had 5 times more likely to utilize post abortal family planning as compared to the women who were nullyparous [AOR: 5.314, 95%CI (1.089, 24.210), p value=0.001]. Conclusion and Recommendation: From a total of 371 study subjects 45.8% have utilize contraceptive after abortion service received. This study also showed that parity and counseling’s of family planning were statistically significant associated with utilization of post abortal family planning. We recommend Debre Berhan hospital to scale up activities on post abortal care to increase the number of clients who post abortal family planning.
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Thirteen steps for office hysteroscopy with minimal discomfort

Published on: 27th June, 2019

OCLC Number/Unique Identifier: 8193600756

The Office hysteroscopy (OH) is a important procedure to make diagnosis and sometimes, treatment, of intrauterine pathology, without getting the patient to Operating Room. Its advantages are very well known: less costs, fast diagnosis, see and treat and several others. It's mainly difficulty is the discomfort during the procedure. To stimule to grow the number of gynecologist to leave OR and to go to office hysteroscopy, we propose thirteen steps for office hysteroscopy with minimal discomfort.
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Management of temporomandibudar joint ankylosis with costo-chondral graft application: Case report and review of literature

Published on: 27th February, 2020

OCLC Number/Unique Identifier: 8560390804

Introduction: Temporomandibular joint (TMJ) ankylosis is one of the most disruptive anomaly that affects the masticatory system and is referred as permanent movement disfunction of the mandible caused by bilateral or unilateral fibrous or bony adhesions and create problems. The etiology is congenital or idiopathic and include trauma, arthritis, infection, previous TMJ surgery etc. Management requires extensive resection of the ankylotic mass and reconstruction of the ramus-condyle unit with autogenous or alloplastic grafts. Most of the time, combination of surgical treatment with physiotherapy is needed in order to achieve maximum rehabilitation and functionality of the mandible. Purpose: The aim of this study is to present the surgical management of an unusual case of unilateral TMJ ankylosis and recent of literature review. Case report: A thirty-seven-year old patient reported unable moving his lower jaw. Clinical examination revealed unilateral TMJ ankylosis of congenital cause and the lateral movement of the mandible was impossible. The patient surgical treatment included resection of the newly formed bone mass, replacement of the condyle with costo-chondral graft and replaced of articular disc with the temporal fascia. Since and for ten years after surgery the patient shows no signs of relapse. Conclusion: The development of TMJ ankylosis may be congenital or acquired etiology. In order to manage it required a comprehensive clinical and radiographic examination. Surgical resection of the bone and coronoid process on the entire side is necessary and a graft that mimics the articular disc is placed, while it is necessary the immediate postoperative kinesiotherapy.
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Twin-stage technique for occlusal rehabilitation of a mutilated dentition – A case report

Published on: 28th May, 2020

OCLC Number/Unique Identifier: 8627834705

Functional and aesthetic rehabilitation of an extremely worn dentition is one of the most challenging aspects of Prosthodontics. A thorough examination and diagnosis & selection of appropriate occlusal scheme are key factors to achieve optimal clinical outcome. Among the variety of techniques suggested in the literature, the twin-stage technique given by Hobo & Takayama has emerged as a popular choice for clinicians in recent times. Instead of the condylar path, it utilizes standard cuspal angle as the main determinant of articulation to produce predictable disocclusion in eccentric movements. It is relatively simple, does not require special armamentarium and can be incorporated easily with commonly used clinical techniques such as face bow transfer. The present case report describes the full mouth rehabilitation of a severely mutilated dentition using Hobo’s twin-stage technique to achieve a functionally and aesthetically favourable outcome.
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Methotrexate in management of Morbidly Adherent Placenta at Latifa Hospital, DHA, Dubai, UAE.: Case report

Published on: 12th July, 2019

OCLC Number/Unique Identifier: 8192121249

Morbidly adherent placenta (MAP) includes the spectrum of placenta accreta, increta, and percreta. It is a major cause of obstetric hemorrhage. Caesarean section is main risk factor for MAP. Ultrasound scan is highly sensitive method for MAP diagnosis and sometime Magnetic resonance image is of choice. Early diagnosis timed elective planned intervention after preparation under skillful multidisciplinary team improve the outcome and minimize the morbidity. Caesarean hysterectomy, major arteries ligation, arteries embolization and leave the placenta in-situ all are choices of management. Use of Methotrexate for the placenta in-situ in MAP is still debatable. We present a case of MAP in which placenta left in- situ followed by multiple Methotrexate injection during postpartum with good outcome and acceptability.
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Intraperitoneal and Subsequent Intravenous Vancomycin: An Effective Treatment Option for Gram-Positive Peritonitis in Peritoneal Dialysis

Published on: 20th April, 2017

OCLC Number/Unique Identifier: 7317634403

Intraperitoneal vancomycin absorption is higher when there is peritoneal inflammation, but the absorption decreases with recovery from peritonitis. Consequently, intraperitoneal maintenance doses are ineffective, reducing the rate of cure. Aim:To evaluate the outcome of Gram-positive peritonitis treated with intraperitoneal and subsequent intravenous vancomycin. Methods: In April 1996, we initiated a protocol for treating peritonitis caused by Gram-positive organisms using a 2-g intraperitoneal loading dose of vancomycin followed by intravenous vancomycin at 1 g twice in 5 days for coagulase-negative Staphylococcus and at 1 g three times in 5 days for Staphylococcus aureus. We analyzed episodes of Gram-positive peritonitis (coagulase-negative and S. aureus) and the efficiency of the treatment protocol in 113 patients undergoing peritoneal dialysis between 1 April, 1996 and 3 August, 2016. There were 6090 patient-months and the mean treatment lasted 54±44 months. The outcomes were evaluated as (1) complete cure, (2) relapsing peritonitis, (3) catheter removal for refractory peritonitis, and (4) death. Results: A total of 51 cases of coagulase-negative Staphylococcus peritonitis and 37 of S. aureus were seen in 46 of the 113 patients (40.7%). Of these, coagulase-negative Staphylococcus (92.15%) and 34 S. aureus peritonitis (91.89%) resolved. Conclusion:The response to treatment was very satisfactory.
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Anemia response to Methoxy Polyethylene Glycol-Epoetin Beta (Mircera) versus Epoetin Alfa (Eprex) in patients with chronic Kidney disease on Hemodialysis

Published on: 5th September, 2017

OCLC Number/Unique Identifier: 7317633426

Objective: Anemia, a common complication of chronic kidney disease, usually develops because of erythropoietin deficiency. Maintaining target hemoglobin (Hb) with minimal variability is a challenge in hemodialysis (HD) patients. The aim of this study is to compare the long- and short-acting erythropoietin erythropoietin stimulating agents such as Mircera and Eprex in achieving these targets. Results: The response rate in the evaluation period was higher in patients treated with methoxypolyethylene glycol-epoetin beta (Mircera) than with epoetin (Eprex) alfa: 36 of 50 (72%) mean Hb concentration (10.51g/dl) versus 29 of 50 (58%) mean Hb concentration (9.81), with statistically significant p-value <0.0001. Conclusion: Treatment with (Mircera) administered intravenously once monthly was superior to treatment with (Eprex) administered subcutaneously three times weekly for maintaining haemoglobin concentrations in patients with chronic kidney disease on hemodialysis.
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Intracerebral Hemorrhage of Brainstem in triple pregnancy after in vitro fertilization by receiving Ovum Donation: A case report and review

Published on: 16th December, 2019

Deliveries prior to 28 weeks’ gestation (extreme preterm birth) pose a global health concern, according to the World Health Organization (WHO). Extreme preterm birth is associated with several complications in the newborn and management in neonatal intensive care unit would incur high expenses. In parallel, advancements in in vitro fertilization will give an opportunity for women to conceive in cases of ovarian failure. At the same time, health providers also encourage patients to receive more than one embryo simultaneously during an embryo transfer. Here we report a case of a patient in coma condition of triplet pregnancy, post ovum donation with three-embryo transfer. Following stabilization, cranial computed tomography (CCT) was performed. The result showed bleeding in the brainstem and into intraventricular spaces at 25+4 gestation weeks. Furthermore, ICH during pregnancy is considered as a rare case in obstetrical field, especially involving the brainstem. This could lead to life-threatening conditions and serious disability in the future. On the fifth day of hospitalization, she suffered from pneumonia and pulmonary edema. On the eight day (26+5 gestations weeks), an emergency caesarean section was performed due to fully dilated of the cervix with breech presentation of all fetuses. Mother and the children survived with some non-life-threatening disabilities. This is the very first case reported of intracerebral hemorrhage in the brainstem in triplet pregnancy after receiving ovum donation. Heterologous conception could be an iceberg phenomenon of gestational complications among the population. Reproductive tourism could still become greater in the future. 
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Comparative effect of calcium supplementation on the incidence of pre-eclampsia and eclampsia among primigravid women

Published on: 17th December, 2019

OCLC Number/Unique Identifier: 9272372141

Background: Pre-eclampsia is a frequent and serious pregnancy complication contributing for the increasing maternal morbi-mortality rates. This study was designed to evaluate the effect of calcium supplementation during pregnancy, on the incidence of pre-eclampsia and eclampsia among primigravid women. Method: In a hospital-based, opened, randomized and controlled clinical trial carried out in the city of Yaounde, 70 women were randomized to either 1.5 g daily calcium supplements (n = 35) or vitamins at the same time (n = 35) from 20 weeks gestation till delivery. Were included all singleton healthy, primigravid women who offered their signed inform consent and were excluded, all women with any chronic condition. Primary outcomes were pre-eclampsia and eclampsia. Results: No significant difference was observed between the two study groups with respect to the baseline characteristics obtained at enrollment. We recorded a sevenfold decrease in the incidence of preeclampsia in the calcium group (RR = 0.26, CI 0.06 – 0.44, p = 0.024). The onset of pre-eclampsia was delayed 3 weeks in the calcium group. Meanwhile the mean diastolic blood pressure at delivery was of no significant difference (p = 0.126), the mean systolic blood pressure at delivery however, presented a significant difference between both groups (p = 0.009). Conclusion: A 1.5 g daily calcium supplementation of healthy normotensive primigravid women during pregnancy seems to be effective in reducing the incidence of pre-eclampsia. 
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Histological clonal change - A feature for dysplasia diagnosis

Published on: 28th August, 2018

OCLC Number/Unique Identifier: 7856144153

Aims: Histological diagnostic criteria are used for the assessment of the degree of dysplasia and hence the risk of cancer progression for premalignant lesions. Clonal changes in the form of hyperorthokeratosis and hyperchromasia that are sharply demarcated from adjacent areas are not currently part of the criterion for dysplasia diagnosis. The objective of this study was to determine whether such clonal change should be regarded as a diagnostic feature for dysplasia. The following histological conditions were used to define such change: (1) hyperorthokeratosis; (2) hyperchromatism but no other features of dysplasia; (3) sharp margin demarcation from adjacent area by both the hyperorthokeratosis and hyperchromasia (clonal change), and (4) no prominent rete ridges, marked acanthosis or heavy inflammation. Lesions fitting these criteria were termed orthokeratotic lesions with no dysplasia. Methods: Patients from a population-based longitudinal study with more than 10 years of follow up were analyzed. Of the 214 patients with primary oral premalignant lesions, 194 had mild or moderate dysplasia (dysplasia group) and 20 fit the criteria for orthokeratotic lesions without dysplasia (orthokeratotic with no dysplasia group). The two groups were compared for their cancer risks using clinical (site and toluidine blue), histological (nuclear phenotype score), and molecular criteria (loss of heterozygosity) and by outcome (progression). Results and conclusions: The lesions from orthokeratotic with no dysplasia group showed a similar cancer risk (clinical, histological and molecular risk) and time to progression as the dysplastic lesions. We recommend that the clonal change should be included as a criterion for dysplasia diagnosis
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