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Introduction: Implementation of prevention strategies for patients with coronary artery disease (CAD) is essential, but many fall short of reaching their goals. Patients often perceive themselves as healthy and are less motivated to change lifestyle. To obtain better results patients need repeated information, preferably with motivational and person-centered approaches. Aims: To investigate whether health care providers inform CAD patients about risk factors and lifestyle changes at a percutaneous coronary intervention unit. Also to investigate whether the information given at discharge included secondary prevention management and if motivational and person-centered approaches were used. Methods: This is a descriptive, observational study that includes both a qualitative and quantitative design. Physicians and nurses working at a percutaneous coronary intervention (PCI) unit and physicians at a coronary care unit (CCU) participated. A staff nurse observed and noted what information the patients received at the PCI unit. At the CCU, observations regarding secondary prevention strategies during the discharge counselling were performed. Results: There were 50 observations made at the PCI unit. The information mainly consisted of tobacco consumption, physical activity and diet. During the 31 discharge counselling sessions the diagnosis, interventional procedure and medical treatment were frequently included. Most patients received little or no person-centered or motivational counselling. Conclusion: Nearly all patients at the PCI unit received information about the consequence of tobacco consumption, and more than half about the beneficial effects of physical activity. In contrast, the counselling at discharge need to focus more on behavioral changes and a motivational and person-centered approach.

For 51 days, Gaza was pummeled down by the Israeli military in a war known as Operation Protective Edge. During the 50 days (7-7-204 to 28-8-2014) of the Israeli campaign, 2104 Palestinians were killed, including 253 women (12%) and 495 children (24%). According to the UN, at least 69% of Palestinians killed were civilians. It is estimated that 10,224 Palestinians, including 3,106 children (30%) and 1,970 women (19%) were injured. Preliminary estimates indicate that up to 1,000 of the children injured will have a permanent disability and up to 1,500 orphaned children will need sustained support from the child protection and welfare sectors, 17,200 homes destroyed or severely damaged, 58 hospitals and clinics damaged [1]. Major stressful events are well documented to increase the incidence of acute cardiac events [2]. Cardiovascular complications more than doubled during the FIFA World Cup games of 2006 [3]. After the September 11 terrorist attacks, significantly more patients presented with acute myocardial infarction to the hospitals in Brooklyn [4] and New Jersey [5]. We were able to examine the effects of the Isreli attacks on acute STEMI presentations in Gaza city.

Statement of problem: Provisional restorations play a critical role in the success of restorative treatment so they must maintain their integrity in the oral environment throughout the diagnostic and restorative phases. Purpose: The aim of this study was to compare and evaluate the hardness of four different materials used fabrication of interim restoration. Material and methods: Ten samples with dimensions of 10mmx10mmx2mm were fabricated from four interim materials (DPI, Tempron, Protemp 4 and Transcan). Hardness of samples was measured using Fischer scope hardness tester. Result: The highest mean hardness was found in Heat polymerizing acrylic resin group. ANOVA test indicated F value to be 2201.01 which was highly significant (p < 0.001). Conclusion: Heat polymerizing resin and bisacrylics may be considered in a long term provisional fixed prosthesis.

Introduction: Candidiasis is more frequent in human immunodeficiency virus (HIV)-infected patients and knowledge about the distribution and antifungal susceptibility of oral Candida species is important for effective management of candidiasis. Material and Methods: An oral rinses sample collected from hundred HIV-infected patients with and without clinical evidence of oral candidiasis in this study at the Infectious Department/Tripoli Medical Center, Libya. Species identified by standard phenotypic and conventional methods and in vitro susceptibility testing of the yeast isolates to antifungals were performed using the Disc diffusion method protocol as recommended by the Clinical Laboratory Scientific Institute. Results: Oral Candida colonization is detected in all patients with and without clinical syndromes, and Candida albicans were accounted for (74%), C. dubliniensis (11%) and C. glabrata (6%). A high proportion of Candida species (42%) showed decreased susceptibility to fluconazole. Among C., albicans more than 30% of isolate were resistant to most new azole antifungal including fluconazole, itraconazole, posoconazole and voriconazole. Conclusions: A significant number of oral Candida species particular Candida albicans exhibiting decreased susceptibility to fluconazole were isolated from colonized HIV-infected individual, given the high incidence and severity of fungal infections in HIV-infected individuals. The results of this study reinforce the importance of antifungal susceptibility testing, which contributes to the therapeutic strategies and highlights the need for continuous surveillance of Candida colonization in this population.

A Fregoli syndrome, just like Capgras Syndrome, Double Subjective Syndrome, and Inter metamorphosis Syndrome, belongs to the group of delusion misidentification syndromes. It is a rare neuropsychiatric pathology that could affect the brain with repercussions on behavior. It is the belief that a familiar person is disguised as a strange person by taking a different physical appearance but remains the same person psychologically. This entity has heterogonous etiologies, occurring mainly in the setting of organic diseases, affective disorders, or schizophrenia. In this article, we proposed to expose a case of a schizophrenic patient who developed Fregoli syndrome.

Background: Growing evidence has revealed that fear and anxiety related situations could affect cardiac parameters. P wave dispersion (Pd) is an important index. In the present study, we aimed to evaluate Pd values in patients with premenstrual dysphoric disorder. Methods: The study was composed of twenty-five female patients with premenstrual dysphoric disorder and same number of healthy controls. Pd, Pmin and Pmax values were determined by electrocardiogram (ECG) in the subjects. Results: It was found that patients with premenstrual dysphoric disorder had considerably higher Pmax and Pmin values compared to those of healthy subjects. Pd was also significantly higher in patients with premenstrual dysphoric disorders than that of healthy subjects. Conclusion: Study suggests that patients with premenstrual dysphoric disorder seems to have increased Pd, as can be seen in anxiety and fear related clinical conditions, considering that this group of patients have an increased trend to cardiac abnormalities, particularly cardiac arrythmias. To access strong conclusion, it is required novel studies with larger samples.

Brf1 (TFIIB-related factor 1) is a transcription factor, which specifically modulates the transcription of RNA polymerase III-dependent genes (RNA Pol III genes), such as tRNAs and 5S rRNA. The products of tRNAs and 5S rRNA transcription will be changed with the alteration of Brf1 expression. Whereas deregulation of Brf1 and RNA Pol III genes are tightly associated with cell proliferation and transformation, and tumorigenesis. In recent years, emerging studies indicate that Brf1 expression is increased in patients with cancers. In this review, we summarize the progress of the abnormal expression of Brf1 in different human cancers to explore an underlying mechanism and its clinical implication, as well as to prompt its application prospect. With the depth of the Brf1 study and the progress of biotechnology, the status of Brf1 expression may be used as a universal indicator of the early detection and prognosis observation of human cancers.

Background: Early diagnosis and improved facilities are necessary for determining the optimal timing of surgery and other interventions in children with congenital heart diseases in Nigeria. This is because late presentation, late diagnosis and delayed surgery can lead to mortality and affect the quality of life among these children. Objectives: This review article is aimed at enumerating the timing of cardiac surgeries and other interventions and to seek if there is any factor associated with the timing of cardiac surgery. Methods: A search on PubMed database, World Health Organization libraries, Google scholar, TRIP database, and reference lists of selected articles on timing of cardiac surgery in children was done. The Cochrane Database of Systematic Reviews was also searched. We noted few data from African setting. Key words such as timing of cardiac surgery; children, congenital heart defect were used. Conclusion: Appropriate timing for cardiac surgery in children with congenital heart disease is very important as late surgical intervention could result in several morbidities and mortality.

he presence of bifid mandibu¬lar canals is an unusual but not rare occurrence. The mandibular canal containing the inferior alveolar artery, vein, and nerve, originates from the mandibular foramen and terminates at mental foramen [1-4]. In radiology, mandibular canal’s appearance has been described as “a radiolucent dark ribbon between two white lines”[5]. White and Pharoah defined it as “dark linear shadow with thin radiopaque superior and inferior borders cast by the lamella of bone that bounds the canal” [6]. Understanding of its anatomic variations is very important due to its clinical implications in various oral and maxillofacial treatments like removal of wisdom teeth [7], mandibular implant placement [8], in bilateral sagittal split osteotomy procedures and during fixation of mandibular fractures. Presence of bifid or multiple mandibular canals forces the clinician to change the treatment plan. Ignoring this variation can cause several complications intra or postoperatively or even result in failure of treatment. For instance a bifid canal if ignored during surgical removal of third molar or dental implant placement can cause prolonged pain even after administering local anesthesia and also severe bleeding if the accessory canal is encroached [2]. Bifid mandibular canals may originate from the mandibular foramen independently or might bifurcate from a single canal during its course inside the mandible [8]. Bifid mandibular canals have been by classified by multiple authors according to anatomical location and configuration, on panoramic radiographs and computerized tomography. According to Carter and Keen [1], inferior alveolar nerve can be arranged as- Type I: single large bony canal, Type II: canal is lower down in the mandible and Type III: canal separates posteriorly into two large branches. Nortje, et al. [9] gave patterns of duplication as- Type I: duplicate canals from a single mandibular foramen which can be of same size/ lower canal smaller/ upper canal smaller. Type II: short upper canal up to the second molar areas. Type III: two canals from separate foramina, joining at molar area and Type IV: supplemental canals joining the main canals in the retromolar areas. This report describes a case of a bilateral Bifid Mandibular Canal suspected by a panoramic radiograph and confirmed by a CBCT prior to a dental treatment.

Background: There is a paucity of data on the burden of acute kidney injury (AKI) in hospitalized HIV-infected patients in Sub-Saharan Africa in the “test and treat” era.Objectives: To study the incidence, risk factors, and outcomes of AKI among HIV-positive medical admissions in a secondary hospital.Materials and methods: We prospectively screened adult HIV-positive patients who gave their informed consent and were admitted to the Bamenda Regional Hospital for AKI from February to June 2020. We excluded participants with Chronic Kidney Disease (CKD) Stage 5 and those with confounders of serum creatinine. On admission and after 2-7 days, we extracted a venous blood sample from each participant to evaluate serum creatinine and diagnose AKI. The participants were then followed up on until they were discharged or died. We measured the need for dialysis, access to dialysis, and renal recovery at three months for patients with AKI. The amended KDIGO 2012 criteria were used to define and classify AKI. The University of Bamenda’s institutional review board provided ethical approval.Results: A total of 206 participants (39.8% men) were enrolled, with a mean (SD) age of 45.71(13.13) years. On enrolment, 89.8% (n = 185) of the participants were on combination antiretroviral therapy (c-ART), with 81.6% (n = 151) on tenofovir-containing regimens. The WHO HIV clinical stages 3 and 4 were present in 81.5% (n = 168) of the individuals. The most common reason for hospitalization was opportunistic infections (69.8%; n = 142). AKI was found in 30.6% (n = 63) of the patients, with 58.7% (n = 37) of them being classified as KDIGO stage 3. A total of 12 (42.9%) participants out of the 28 in need, were dialyzed. AKI was independently associated with use of traditional medicines (aOR = 2.9; 95% CI 1.4-6.3; p = 0.006), WHO HIV stages 3 and 4 (aOR = 4.1; 95% CI 1.1-15.7; p = 0.038), hypotension (aOR = 3.3; 95% CI 1.4-7.8; p = 0.008) and low haemoglobin level ≤ 8.0 g/dl (aOR = 3.5; 95% CI 1.7-7.4; p = 0.001). The AKI group used to have a significantly higher mortality rate (42.9% vs. 16.1%; p < 0.001). Renal recovery was complete in 66.7% of the 30 survivors at three months, partial in 13.3%, and no recovery in 20% of the survivors.Conclusion: Despite the growing use of combination antiretroviral medication, significant immunosuppression is still common in hospitalized HIV-positive patients, increasing the risk of AKI and worsening prognosis. In this high-risk population, early detection of AKI with renal function monitoring may improve results.