Journal Open Access Macedonian Journal of Medical Sciences

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701 articles
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Adel Hussein Elduma
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 430-434; doi:10.3889/oamjms.2018.099

Abstract:BACKGROUND: Female genital mutilation or female circumcision (FGM) is a serious health problem in Sudan. This procedure is harmful to women and causes many complications during pregnancy and childbirth.OBJECTIVE: This study aims to determine the female genital mutilation (FGM) and its associated factors in Sudan.SUBJECTS AND METHODS: Data from Sudan Multiple Indicator Cluster Survey (MICS - UNICEF) was used in this research. The survey was carried out in 2014 and included women aged between 14 – 49 years. A logistic regression model was used to find an association between dependent and independent variables.RESULT: Total numbers of 21947 women were included in the survey and out of the 6249 (28.5 %) from urban and 15698 (71.5%) from rural areas. The prevalence of female circumcision was 89%. Women who had circumcised daughters were 32.1 %. The highest prevalence of FGM was reported from South Kordofan state with 7.8%, and lowest was in Red Sea state (7.6%). A significant association was observed between circumcised women and their marital status, daughter circumcision, and the level of education.CONCLUSION: The practice of female genital mutilation is spread all over the country. Poor women with low level of education are at high risk for this phenomenon. More efforts have to be provided to end this dangerous practice.
Nova Nexhmije Ajeti, Teuta Pustina-Krasniqi, Sonja Apostolska
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 389-396; doi:10.3889/oamjms.2018.102

Abstract:OBJECTIVES: During the treatment of chronic apical periodontitis and pulp necrosis the main role is to irrigate the root canal.AIM: The aim of this in vivo study was to irrigate with 0.9% NaCl (Natrium Chloride), 2.5 % NaOCl (Sodium Hypochlorite Solution, Sigma Aldrich - Germany) and 2% CHX (Chlorhexidine Digluconate Solution, Sigma Aldrich - Spain) combined with Gaseous Ozone (Prozone WH, Austria).MATERIAL AND METHODS: This study was realised in the University Dentistry Clinical Centre of Kosovo (UDCCK), respectively in the Department of Endodontic and Dental Pathology, Dental Branch, Faculty of Medicine, Prishtina, Kosovo. The 40 subjects involved in this study belonged to both genders, in age between 15 -65 years. The sample selection was randomised. The retroalveolar radiography for each patient was taken in the suspected tooth. As a therapeutic plan the authors decided to disinfect the root canal with the irrigants, as follows: 2.5 % NaOCl, 2 % CHX and gaseous ozone.RESULTS: The statistical analyses were based on Kruskal - Vallis test, X - test, DF = 3, r < 0.01. In the isolated average number of the aerobe and anaerobe bacteria colonies, when gaseous ozone was used, there was the significant statistical difference.CONCLUSIONS: When gaseous ozone was combined with irrigants 0.9%, 2.5 % NaOCl and 2% CHX, it was concluded that the number of colonies of aerobic and anaerobic bacteria was reduced.
Hamed A. Hamed, Hamdy A. Marzook, Nahed E. Ghoneem, Mohamed I. El–Anwar
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 397-401; doi:10.3889/oamjms.2018.077

Abstract:AIM: This study aimed to evaluate the effect of different implant angulations in posterior maxilla on stress distribution by finite element analysis and verify its results experimentally.METHODS: Two simplified models were prepared for an implant placed vertically and tilted 25° piercing the maxillary sinus. Geometric models' components were prepared by Autodesk Inventor then assembled in ANSYS for finite element analysis. The results of finite element analysis were verified against experimental trials results which were statistically analysed using student t-test (level of significance p < 0.05).RESULTS: Implant - abutment complex absorbed the load energy in case of vertical implant better than the case of angulated one. That was reflected on cortical bone stress, while both cases showed stress levels within the physiological limits. Comparing results between FEA and experiment trials showed full agreement.CONCLUSION: It was found that the tilted implant by 25° can be utilised in the posterior region maxilla for replacing maxillary first molar avoiding sinus penetration. The implant-bone interface and peri-implant bones received the highest Von Mises stress. Implant - bone interface with angulated implant received about 66% more stresses than the straight one.
Slavomir Kondoff, Atanas Drenchev, TORELLO LOTTI, Uwe Wollina, Ilia Lozev, Ivan Pidakev, Ivan Terziev, Yavor Grigorov, Serena Gianfaldoni, Georgi Tchernev
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 372-375; doi:10.3889/oamjms.2018.101

Abstract:BACKGROUND: Basal cell carcinomas (BCC) located in the sun-exposed regions are a serious therapeutic challenge. Therefore early diagnosis and adequate therapy should be of a high priority for every dermatologic surgeon.CASE PRESENTATION: We are presenting a patient with multiple BCCs, located on the area of the scalp, who had been treated several years ago with electrocautery and curettage after histopathological verification. However, the last few years the tumours have advanced, infiltrating firstly the tabula external and a year later the tabula interna of the cranium. A computed -tomography (CT) imaging and radiography of the skull were performed to reveal the definite tumour localisation, needed for planning an one - step surgical intervention. Both of the instrumental examinations confirmed the existence of osteolytic tumour lesions. Craniotomy with precise removal of the BCCs infiltrating the cranial bone in all of its thickness was performed. Partial resection of dura mater was also performed also because intraoperative findings established the involvement of the dura. Histopathological verification revealed bone and dural invasion with clean resection margins. The bone defect was recovered with hydroxyapatite cement. Reconstruction as the shape of the skull was carefully modified and adapted to its initial size and form. Layered closure of the skin and soft tissues were performed after the complete removal of the BCCs. The postoperative period had no serious complications.CONCLUSION: Precisely managed therapy of BCC is curative in most of the cases as it ensures good prognosis for the patient.
Salim Şentürk, Ahmet Öğrenci, Ahmet Gurhan Gurcay, Ahmet Atilla Abdioglu, Onur Yaman, Ali Fahir Ozer
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 359-363; doi:10.3889/oamjms.2018.094

Abstract:AIM: Burst fractures can occur with different radiological images after high energy. We aimed to simplify radiological staging of burst fractures.METHODS: Eighty patients whom exposed spinal trauma and had burst fracture were evaluated concerning age, sex, fracture segment, neurological deficit, secondary organ injury and radiological changes that occurred.RESULTS: We performed a new classification in burst fractures at radiological images.CONCLUSIONS: According to this classification system, secondary organ injury and neurological deficit can be an indicator of energy exposure. If energy is high, the clinical status will be worse. Thus, we can get an idea about the likelihood of neurological deficit and secondary organ injuries. This classification has simplified the radiological staging of burst fractures and is a classification that gives a very accurate idea about the neurological condition.
Edlira Lashi, Fatos Lashi, Klotilda Muca, Bora Ballta, Suzana Kazazi
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 355-358; doi:10.3889/oamjms.2018.065

Abstract:AIM: Identification of glycemic level tendency rates in a hypertonic population that suffers from diabetes mellitus in Health Centre Nr. 1, Tirana, evaluation of self-monitoring and the effects of interactions, with the aim of reducing the levels of fast glycaemia in these patients.MATERIAL AND METHODS: In the study participated 810 patients of Health Centre Nr 1 in Tirana that suffer from hypertension and diabetes mellitus type 1 and 2. The study was conducted through 10 months’ period. The patients that owned glucometer passed through the process of calibration of the devices, the others that had no glucometer had been given one. All the patients had been instructed how to use the device properly. Informative and educative materials regarding hypertension and diabetes were given to them. A standardised table was used to collect all the data. Changes in therapy were done regarding the glycemic levels.RESULTS: The most of the patient shown an important improvement in glycemic rates during ten months of study. From 810 patients, 617 of them shown an improvement of the glycemic level data (median = 24 mg/dl; IQR: 14 – 50 mg/dl), and the other 193 patients have shown no improvement (n = 11) or aggravation (n = 182). The data showed that the patients that had no improvement during the study have diabetes type one (40%), they that have shown improvement has diabetes type 2 (33%) The difference between 2 those groups were insignificant (p = 0.075). The data of glycemic levels shown a significant decreased of 19% of basal glycemic levels (128 ± 31 vs. 158 ± 55 mg/dl: p < 0.05) at the end of the study, and decreased of glycemic levels was visible especially after the first month of the study, in both groups male and females.CONCLUSION: A total of 205 therapy changes like adding a new or two drugs or an increase of doses of the drugs, are done in some 181 patients that have diabetes, with a frequency of 1.1 changes in therapy per patient.
Nova Zairina Lubis, Kamaliah Muis, Lukmanul Hakim Nasution
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 280-283; doi:10.3889/oamjms.2018.098

Abstract:BACKGROUND: Onychomycosis is a fungal infection of one or more units of the nail caused by dermatophytes, or mould and nondermatophytes yeast. Investigations are needed to establish the diagnosis of onychomycosis before starting treatment. Several investigations methods for diagnosing onychomycosis are microscopic examination with 20% KOH, fungal culture, histopathology examination with PAS staining (Periodic acid Schiff) and PCR (Polymerase Chain Reaction). Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) is a method after PCR amplification allowing more specific results.AIM: To determine the diagnostic value of PCR - RFLP in the diagnosis of onychomycosis using fungal culture as the gold standard and to find out the majority fungal species that cause onychomycosis.METHODS: This study is a diagnostic test for the diagnosis of onychomycosis by using culture as the gold standard.SUBJECTS: Thirty - five patients suspected of having onychomycosis from history and dermatological examination.RESULTS: PCR - RFLP in the diagnosis of onychomycosis has a sensitivity of 85.71%, specificity of 28.57%, positive predictive value (PPV) of 82.76% and negative predictive value (NPV) of 33.33%. The positive and negative likelihood ratios are 1.20 and 0.5 with an accuracy of 74.29%.CONCLUSIONS: PCR - RFLP may be considered for a faster and more accurate alternative examination in the diagnosis of onychomycosis.
Ghassan M. Al-Irany, Fareedi Mukram Ali, Naima H. Alnami, Sahar K. Almashhur, Maha A. Adawi, Abrar A. Tairy
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 402-405; doi:10.3889/oamjms.2018.072

Abstract:Medical emergencies are one of the most stressful situations the staff in a dental practice might encounter. The duty of care toward the attending patients obligates suitable preparedness to provide the necessary care if such emergencies ensue. Unfortunately, we found that 22% of the investigated dental clinics had no emergency kit available. Only 38% of the interviewed dentists felt confident to perform CPR, and 18% had no confidence to manage any medical emergency. An MCQ test of 20 questions examining the dentists’ knowledge in medical emergencies was distributed, and the level of knowledge was found to be suboptimal. The average score of the interviewed dentists was 10.87 out of 20. Experience and specialty training had a negligible effect on the level of knowledge.
Kiking Ritarwan, Aznan Lelo, Yunita Sari Pane, Nerdy Nerdy
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 287-292; doi:10.3889/oamjms.2018.093

Abstract:AIM: To study the protective effect of medicines on the formation of atherosclerosis in mice, it is needed to conduct the study in mice which is not genetically diabetic mice induced by streptozotocin (STZ) to produce hyperglycemia and atherosclerosis, compared with mice treated by yolk or its combination.MATERIAL AND METHODS: Fifty-six mice, Double Deutch Webster strain, male, receive 10 weeks, 20 - 30 gr bodyweight were divided into 4 groups (n = 14) i.e. control (do not received any agents), STZ (45 mg/kg/BW was injected intraperitoneally for 5 days), yolk (0.2 cc orally daily for 6 weeks), and combination of STZ and yolk (STZ: 45 mg/kg/BW intraperitoneally add 0.2 cc yolk orally). All animals were executed in the 42nd day. Then, the aorta of the mice’s heart tissue was histopathology examined. Blood glucose and cholesterol levels were determined every week.RESULTS: Hyperglycemia occurred in mice induced by STZ injection with the highest BGL (521.8 ± 48.2 mg/dl; 188.4%) in the 4th-week observation; after that BGL decrease. We found that, except the control, all treatment groups with STZ, egg yolk, and combination underwent atherosclerosis.CONCLUSION: The present study was able to demonstrate the occurrence of atherosclerosis in mice treated by STZ accompanied with increasing blood glucose and cholesterol level.
Georgi Tchernev, Ivan Terziev
Open Access Macedonian Journal of Medical Sciences, Volume 6, pp 376-377; doi:10.3889/oamjms.2018.108

Abstract:For the first time in the world medical literature, we describe a rare form of cutaneous dermatophytosis – a bullous form of Tinea incognito, classified by clinical picture, histopathological findings and an isolated infectious agent from the microbiological culture. After a thorough review of Medline/PubMed's relevant literature, we could not find similar cases of patients with Tinea incognito who are clinically presented with bullous lesions at the same time. Local application of corticosteroids in infants with unknown lesions may lead to progression of the underlying disease and may cause some serious problems in differential diagnosis aspect, while the clinical expression remains completely masked. Exactly for this reason, right at the beginning of the clinical complaints, a skin biopsy should be obligatorily performed in parallel with microbiological swabs. If there is no improvement after the local corticosteroid application, then diagnosis revision and change of the strategy of clinical behaviour would be appropriate to be done. The systemic treatment that we performed with Fluconazole 50 mg in combination with the local antimycotic agent for a 2-week period led to complete remission.
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