Niger J Clin Pract
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Widening the breadth of dentists' responsibilities to include screening all patients for life-threatening diseases, such as head and neck cancer (HNC), is crucial to improve survival rates and decrease morbidity. ⋯ There is an apparent lack of essential concepts of the behavior and knowledge in our dental community with respect to screening and managing patients with HNC. More emphasis should be placed on updating information on clinical practices and having dentists familiarize themselves with HNC screening methods and tools. Ultimately, the role of the dentist should include screening and detecting systemic diseases in dental settings.
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To investigate the effect of platform switched short dental implants and subcrestal placement on von Mises stress in the maxillary anterior region (D3 bone) by using three-dimensional finite element model analyses (3D FEM). ⋯ Numerical results from the current study suggest that, for short implants, implant diameter is considered more effective design parameter than implant length. Current findings state that platform switch short subcrestal implants results in conservation of marginal bone loss along with better stress distribution around peri-implant regions in D3 bone. However, all models analyzed in this study showed development of von Mesies stresses within physiological limits for human cortical bone.
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Observational Study
The prognostic value of ischemia-modified albumin in patients with sepsis.
Sepsis is a significant contributor of mortality all over the world. Emergency departments have a critical role for diagnosing a suspected sepsis in a patient, since early and proper administration of antibiotics may decrease mortality significantly. But, the unavailability of an objective and reliable diagnostic test is the major challenge of this critical issue. ⋯ The main reason for the similarity between groups regarding IMA levels was thought to be associated with the distribution of the acute and chronic health problems other than sepsis in the control group. Emergency department physicians should not only depend on serum IMA levels for predicting the prognosis of patients with sepsis or septic shock.
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Case Reports
Testicular torsion: Losses from missed diagnosis and delayed referral despite early presentation.
Testicular torsion leads to loss of blood supply to the testes due to the twisting of the spermatic cord and its contents, necessitating urgent surgical intervention to salvage the affected testis. Testicular loss from missed diagnosis and delayed referral is preventable, especially when patients present early to first contact health care workers. This makes having the correct diagnostic knowledge for testicular torsion by these first contact healthcare providers a very essential determinant of its overall outcome. ⋯ Their diagnoses were missed and referrals were delayed despite presenting within three hours of onset of symptoms. It led to the removal of the affected testis in both patients. This case series emphasizes the need to regard every testicular pain in children and young adults as testicular torsion until proven otherwise and highlights the importance of training the first contact health care providers on recognition and prompt intervention or referral of patients with testicular torsion.
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Gonorrhoea is a sexually transmitted infection (STI) that increases the risk of infection with human immunodeficiency virus (HIV) and causes infertility and urethral stricture. We describe three cases of sexually active men, otherwise stable, who presented with a history of painful micturition and creamy white, urethral discharge. A clinical diagnosis of gonococcal urethritis was made and confirmed by microscopy, culture and 16SrRNA. ⋯ Patients did well and were followed up for 5 months. Contact tracing was done for their sexual partners. While it is also important for healthcare workers to familiarize themselves with current treatment guidelines for gonococcal urethritis, the place of clinical laboratory in the management of STIs, with molecular techniques and the need for surveillance for MDR Neisseria gonorrhoeae cannot be overemphasized.