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The aim of this publication is to present case reports to show what is possible with pterygoid implants for the rehabilitation of edentulous space in the jaw (maxilla) while avoiding sinus lifts and bone grafting procedures. In addition, the added value of one-piece implants for screwed retention is elucidated.

Background and aim of the study: Sutureless aortic valves are used to reduce operation time. However, the stent implantation might cause postoperative ECG alterations and a higher risk of paravalvular leakage. In literature, some cases of thrombocytopenia are described after implantation. We investigated the Sorin Perceval S Sutureless Valve and the Edwards Intuity Sutureless Valve.Material and methods: Seventy-nine patients underwent aortic valve replacement using a sutureless valve in a single center between 2015 - 2018. Thirty-seven patients received Sorin Perceval S (Group A) and 42 Edwards Intuity (Group B). Simultaneous bypass surgery was performed in 23 patients in Group A and 22 patients in Group B. We compared the groups regarding postoperative TTE and paravalvular leakage, postoperative ECG alterations, need for pacemaker implantation, postoperative platelet count, and 30-day mortalityResults: Only in Group B 2 patients had paravalvular leakage, and one was reoperated within the same hospital stay. In Group A, nine patients suffered from postoperative atrial fibrillation, and in Group B, 16 patients. Left bundle branch block (LBBB) was observed in 5 patients in Group A, and 13 patients in Group B. Two patients in Group A needed a definite pacemaker, and five patients in Group B. Tachy-Brady Syndrome and LBBB were observed more frequently in Group B as well as ECG alterations. One patient died within 30 days in Group A due to multiorgan failure. This patient was older and multimorbid compared to the average. Regarding platelet count, we saw a statistically significant decrease in both groups. There were no major bleeding complications or reoperations due to hemorrhage.Conclusion: Our data shows that sutureless aortic valve replacement is associated with new postoperative ECG alterations, which are self-limiting in most cases. Compared to the literature pacemaker implantation rate in Group B is higher.

Desmodium adscendens is a rain forest medicinal herb used in managing quite a number of medical conditions. Its efficacy in the treatment of several diseases has made it a first line herb for doctors, especially in managing all forms of spasm. It is however common knowledge that some of these medicinal herbs impact severely on the normal functioning of some vital organs of the body during their administration. The present study was carried out to assess the renal and cardiovascular performance in subjects undergoing treatment with Desmodium adscendens with a view to advising against its indiscriminate use. The parameters used for the assessment of renal functions were serum creatinine and urea concentrations and their clearance. Also, changes in electrolyte concentration of Sodium, Potassium and Chloride concentration were used to assess cardiovascular performance. The histology of the kidney and heart tissues was also done to determine if the extract has impact on the cyto-architecture of the organs. Twenty-four (24) wistar rats were used for the experiment. The rats were grouped randomly into four groups (n = 6). Group 1 served as control, and the rats in the group were given normal rat feeds and water. Group 2 served as low dose group, and rats in this group were administered with low dose of extract 300 mg/kg. Group 3 served as medium group, and rats in this group were treated with medium dose of extract, 450 mg/kg. Group 4 served as high dose group, and rats in this group were treated with high dose of extract 600 mg/kg. The extract was administered for 28 days. Result showed that the extract did not impact negatively on the normal function of the renal and cardiovascular system of the treated groups, rather it enhanced their performances. It can therefore be concluded that the extract is beneficial to renal and cardiovascular functions if used within the treatment dosage. 

Objective: to determine the incidence of HBV and HCV in pediatric ward. Sitting: 2ed March teaching hospital, sebha Libya. Materials and Methods: this was a prospective hospital base study of pediatric cases admitted to 2ed March teaching hospital during a period from March 2018 to February 2019. Pediatric cases were studied for the incidence of HBsAg and HCV Ab by ELISA, Rapid technique. The positive result was confirmed with line immuno-assay. Results: the study showed positive HBsAg in 12 patients and HCV in 2 cases out 25 cases represented with acute hepatitis from a total of 1763 pediatric cases were submitted in this study, with incidence rate of 0.68% and 0.11% respectively. Conclusion: the incidence of HBV and HCV are low in Sebha, therefore active program need to be applied to control the spread of infection among the population.

Purpose: The purpose of the study was to evaluate which ocular parameters have an impact on visual results obtained after an extended depth of focus (EDF) wavefront-designed intraocular lens (IOL). Setting: The study was conducted in three Italian centers (private practice in Lucca and two ambulatory surgical centers in Pisa and in Rome) from 01/09/2014 to 30/09/2015.Design: The study population included 178 eyes of 91 patients who had cataract surgery and implantation of an EDF wavefront - designed IOL (Mini Well Ready - SIFI Med Tech S.r.l.).Methods: Preoperative and postoperative refractive corneal spherical aberration (SA), ocular axial length, or anterior chamber depth were measured.Results: The majority of patients were spectacle-independent for near, intermediate, and distance vision and no one reported disturbing halos or glare. No overall significant differences were observed when stratifying anterior chamber depth (ACD) and ocular axial length (AL) by uncorrected distance visual acuity (UCDVA); p = 0.465 and 1.000 respectively, corrected distance visual acuity (CDVA); p = uncorrected near visual acuity (UCNVA); p = 1.000 and 0.728 respectively; p = 1.000 under both parameters and halos; 1.000 under both parameters. Still, there was a statistically significant difference when stratifying SA with 5 mm only by UDVA (p = 0.040).Conclusion: These results are consistent with similar outcomes in the scientific literature as measured with tests of visual acuity, either with or without optical correction. We also demonstrated that these IOLs can be used in myopic and hyperopic eyes, although it may be useful to evaluate the preoperative corneal SA to achieve better results.

Rheumatic heart disease persists as a significant concern in developing regions, often resulting in multivalvular heart conditions. Treatment options are limited, though percutaneous transvenous mitral commissurotomy effectively addresses rheumatic mitral stenosis. Non-surgical interventions for aortic stenosis include balloon aortic valvotomy and Transcatheter aortic valve replacement (TAVR), tailored to patient factors like age and comorbidities.We describe two cases of Rheumatic multivalvular disease which were managed non-surgical. The first case is a pioneering procedure performed on a young patient combined percutaneous transvenous mitral commissurotomy with balloon aortic valvotomy, guided by 4-dimensional transoesophageal echocardiography (4D TEE). This represents the first documented instance in medical literature, showcasing the potential of integrated interventions and advanced imaging techniques. In the second challenging case involving a heavily calcified, retrovirus, and Hepatitis B positive 55-year-old, a staged approach was adopted, involving percutaneous transvenous mitral commissurotomy followed by Transcatheter aortic valve replacement (TAVR). Despite complexities, this sequential strategy demonstrates the adaptability of transcatheter techniques in managing complex valvular pathologies. These cases highlight the evolving landscape of interventional cardiology and underscore the importance of tailored, multidisciplinary approaches in optimizing outcomes for patients with rheumatic heart disease and multivalvular involvement, especially in resource-limited settings. Further exploration and dissemination of such innovative strategies hold promise for enhancing cardiac care quality and expanding treatment options globally.

Portal vein thrombosis (PVT) is a rare condition that may congest bowel venous drainage and cause mesenteric ischemia. In acute settings, gastrointestinal bleeding (GIB) is rare, and acute abdominal pain is the most common clinical presentation. A 24-year-old man who presented with acute abdominal pain and a single episode of hematemesis is reported. Workups revealed evidence of thrombosis in the portal vein, but upper endoscopy was incapable to detect the source of the bleeding. We discuss the possible scenarios for the GIB in this case and review similar reports in the literature.

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the most severe form of congenital malformation of the inner female reproductive tract. It is diagnosed as such when the uterus, the upper vagina and optionally the Fallopian tubes are absent. It accounts for approximately 1 in 5000 live-born females and has been classified in two subtypes: type 1 in the presence of isolated uterovaginal aplasia and type 2 when associated in various combinations with extragenital malformations of the kidneys, skeleton, heart and auditory system. Most cases of MRKH syndrome are sporadic, although a significant number of many familial cases have been reported to date. Despite numerous studies, the genetics of the syndrome remains largely unknown and appears to be heterogeneous: chromosomal abnormalities and some candidate gene variants appear to be associated with a few cases; others have been suggested but not yet confirmed. To date, mainly the GREB1L gene appears to be a serious candidate. Among the remaining hypotheses, the controversial contribution of partial duplications of the SHOX gene is still puzzling, as the deficiency of this gene is a major cause of skeletal adysplasia syndromes. We have attempted to resolve this controversy in a study of 60 MRKH cases. Our results tend to show that SHOX duplications can be the origin of a genetic mechanism responsible for MRKH syndrome.

DNA identification is very important in cases of high decomposition of dead bodies, in which the bodies cannot be identified by physical means.To compare the results of DNA typing, it is necessary to have related subjects with which to perform comparative analyses. Such tests are normally performed by comparing DNA profiles from people known to be immediate family members of the presumptive victim, such as parents or children because they share half of their genetic material with the unidentified.We report on how DNA analysis was used to solve a case of mixed-up bodies at a local mortuary in Ghana, West Africa. Two families and three buried human remains were in contention in this case. The first body (E9) was buried three months before exhumation. The second body (E11) was buried two and a half months before exhumation whiles the third body (E10) was buried a month before exhumation. Exhibit E5 was taken from an alleged child of the deceased, E11. Toenails of the exhumed bodies were sampled by a pathologist and used for DNA extractions using the QIAamp DNA Investigator Kit. Profiles from relatives were generated for comparison purposes. All samples gave a quality amount of genomic DNA after quantification. DNA was amplified with a GlobalFiler PCR amplification kit. Profiles from relatives were generated for comparison purposes.The human remains (exhibit E11) cannot be excluded as the biological father of the child (exhibit E5) because they share common alleles at all 23 genetic loci. The applicable combined paternity index was 17218125604.492 assuming a prior probability of 0.5. The probability of paternity is 99.99999999%. Based on this relationship testing, one of the bodies was successfully identified and handed over to the family for re-burial.

Background: For the prevention of respiratory infection similar to the current pandemic COVID-19, face masks are considered an effective method. Coronavirus disease (COVID-19) is a highly transmittable virus that continues to disrupt livelihoods, particularly those of low-income segments of society, around the world has poor knowledge towards facemask at the same time has huge gape towards attitude which affects the behaviors. Therefore this study was aimed to assess knowledge, attitude, and practice towards facemask use amid the COVID-19 pandemic among public transport drivers in Debre-Tabor town, Ethiopia, 2021.Methods: A cross-sectional study was conducted among 407 public transport drivers in Debre-Tabor town from July to August 2021. The study participants were selected using a simple random sampling technique after proportionally allocating the sample size from the total number of public transport drivers, and finally, study subjects were elected continuously working in Debre- Tabor Town public transport drivers. The data were collected by trained data collectors using a structured questionnaire with face-to-face interview administered questioners and an on-the-spot observational checklist. The collected data were checked, coded, and entered into SPSS version 23, and for data cleaning and analysis.Result: A total of 407 drivers responded to the questionnaire with a response rate of 96.4% were participated in this study. The mean age was 32.75 years (range: 19-45 years). Among them majority was male 383(94.1%) and the majority of 177(43.5%) were Bajaj drives. Among the responders, 114(28%) used radio to gather information, and 41(10.1%) drivers where were caught by COVID-19, but, only 30(7.4%) were vaccinated COVID-19 vaccine. Knowledge, attitude and practices regarding facemask use among these drivers were 368(90.4% [95% CI: 87.7-93.1]). 163(40% [95% CI: 37.5% - 43.2%]), and 23 ((5.6%) [95% CI: 3.7% - 8.3%]) Regarding facemask use against COVID-19 infection respectivelyConclusion and recommendation: The current study was able to demonstrate 90.4% of drivers had good knowledge. Positive attitude and practice levels of face mask use among drivers were less than half of them or 40%, and 5.6% respectively. There is a high supply of Surgical Face masks but poor attitude and practice. Almost all of the participants don’t wear a face mask despite having good knowledge about the transmission routes of COVID-19. The government COVID-19 prevention task force or health sector should be continued their awareness creation to bring behavioral change for the implementation of the COVID-19 prevention method, especially facemask.