The aim of this article is to report three cases of multiple impacted supernumerary teeth and review the literature, analyzing their prevalence, etiology and classification. Supernumerary teeth are those that exceed the normal dental formula. They are more common in men, more common in the upper maxilla, and more prevalent in permanent dentition. Complications associated with supernumerary teeth include dental impaction, delayed eruption, ectopic eruption, overcrowding, spacing anomalies and the formation of follicular cysts. The treatment of supernumerary teeth depends on their type, position, and possible complications, detected clinically and radiographically. No clear consensus exists as to the best time to extract unerupted supernumerary teeth

Background: Hepatitis B virus infection is a major global health problem and of immense clinical importance. Hepatitis B virus infection can lead to hepatocellular carcinoma (HCC) and is found to be associated with macrocytic anemia. The mechanism of anaemia largely depends on red cell membrane integrity. Osmotic fragility (OF) of red cells was therefore evaluated in patients with HBV infections to access the diagnostic/prognostic utility. Methods: A total of 1744 patients from surgical and medical wards/clinics of Alex Ekwueme University Teaching Hospital Abakiliki were screening serologically for HBV using immunochromatographic strip method and positive samples were confirmed by the use of One Step Hepatitis B Multi-5 Test. A total of 100 subjects (50 HBV positive and 50 HBV negative) were evaluated for osmotic fragility of red blood cells. Results: HBV prevalence rate of 3.5% was found among the patients. The osmotic fragility of red blood cells were significantly (p<0.05) decreased in Hepatitis B virus positive individuals compared to Hepatitis B virus negative individuals. Significant (p<0.05) differences were observed in the osmotic fragility of the two groups at 0.9%, 0.8%, 0.7%, 0.6%, 0.5%, 0.4%, 0.3%, 0.2% and 0.1% saline. The mean corpuscular fragility (MCF) which is the sodium chloride concentration causing 50% hemolysis for Hepatitis B positive individuals was 0.33% saline while that of Hepatitis B negative individuals was 0.41% saline. Conclusion: The HBV positive patients showed decreased OF compared with HBV negative control population. This study was on small population of HBV positive subjects without disease staging. Further studies using more sample size and clinical staging is recommended to clearly associate OF as a diagnostic or prognostic marker in HBV infection

Introduction: Incidence of shivering after spinal anaesthesia is common complaint in present anaesthesia practice. Several drugs available to manage shivering such as Pethidine, Tramadol, Dexmedetomidine etc. Among all Dexmedetomidine is effective. This study was designed to assess the efficacy of Dexmedetomidine, Tramadol and Pethidine in the management of shivering under spinal anaesthesia. Materials and Methods: A total 120 cases between age group 21 to 60 years, undergoing elective lower abdominal and lower limb surgeries under spinal anaesthesia method between ASA grade I&II were recruited. Based on drug administered study cases were randomly divided into 3 groups Group 1 with Inj. Tramadol 0.5mg/kg, Group 2 with Inj. Pethidine 0.5mg/kg and Group 3 with Inj. Dexmedetomidine 0.5μg/kg. Heart rate, BP, temperature, Shivering grades and seduction grades was noted for every 5 minutes interval till 15 min and then 15 min interval till 120 minutes. Results: Dexmedetomidine drug was showed better outcome than other drugs. Among the 40 cases, three cases who were given dexmedetomidine had shivering. In tramadol and Pethidine drug groups, 22 and 9 cases had shivering respectively at various time intervals. Dexmedetomidine had onset of sedation at 5 minutes with sedation score 3. In tramadol group, onset of sedation was seen at 15 minutes with sedation score 2. In Dexmedetomidine group, 5 cases had bradycardia and 3 cases had hypotension which was statistically not significant. None of the cases with above symptoms was found in tramadol and Pethidine group. Conclusion: Dexmedetomidine 0.5 μg/kg has been shown effective in reducing shivering than tramadol 0.5 mg/kg and Pethidine 0.5 mg/kg. Dexmedetomidine had higher degree of sedation rate than tramadol and Pethidine

Hypertension is a major cause of morbidity and mortality worldwide. Patients’ beliefs and knowledge about hypertension have a strong influence on compliance to treatment and control of the disease. Up to date, there is no previous data on hypertension health beliefs in Bahrain. Therefore, this research was conducted to study patients’ beliefs and explore the association between patients’ characteristics and their beliefs. Aim: To understand Bahraini patients’ beliefs about hypertension in primary health care in Bahrain. Objectives: To explore patients’ beliefs about hypertension in primary health care in Bahrain; to study the association between personal characteristics (demographic, socioeconomic and medical) and patients’ beliefs. Study design: Cross-sectional study. Settings: Data was collected from two primary care health centers in each health region in Kingdom of Bahrain using validated questionnaire. Participants 454 hypertensive adult Bahraini patients ≥18 years, who were attending primary care within 10 days period in February 2018 (1st – 14th February), were recruited. Pregnant women, patients with psychotic disorder or cognitive impairment, and patients who are unable to communicate were excluded. Data was analyzed qualitatively for themes using SPSS version 23.0. Results: Patients’ mean age was 58.2 ± 11.697 years with females constituting 58.4%. Based on the Health Beliefs Model, participants have strong beliefs regarding their susceptibility to the effects of hypertension, seriousness of its complications and the benefits of a proper and healthy management plan. On the other hand, they have weak beliefs in the efficacy of the barriers (i.e. alternative medicine and medication side effects) toward hypertension management. The most variables having the largest influence on patients’ beliefs were duration of having hypertension and existence of other chronic medical problems. Conclusion: The findings suggest that participants were fairly knowledgeable about hypertension. We concluded that patients’ perceptions are an important factor in hypertension care and should be deeply explored

Progressive multifocal leukoencephalopathy (PML) is a demyelinating condition secondary to lytic infection of oligodendrocytes by JC papovavirus occurring in the context of immunodeficiency. Its aggravation after initiation of antiretroviral therapy is part of the immune restoration syndrome (IRS), often fatal if not adequately managed. We report a clinical observation highlighting the dual role of MRI on the one hand in the diagnosis of PML; allowing the discovery of an HIV infection in our case; and other parts in the follow-up of this pathology which can be complicated by a life-threatening IRS. Cerebral MRI is the main imaging medium for the presumptive diagnosis of PML. In MRI, MRI can be used to assess worsening of lesions by increasing their size as well as by the presence of a contrast enhancement after gadolinium injection indicating inflammation. Thus the use of cerebral MRI in a fragile field such as HIV should be performed periodically even in the absence of suggestive clinical signs, to ensure early diagnosis and adequate management and therefore a better prognosis

Public waste disposal workers in Cross River State do not take precautionary measures and are exposed to waste that generates gases, dust and microorganisms. Spirometry and respiratory symptoms in public waste workers in Cross River state, Nigeria was studied with the aid of a spirometer and questionnaire respectively. Dust and gases (NO2, SO2, H2S and FL) emitted from the vicinity were also studied. Two hundred and forty (240) male subjects were used for the study comprising 120 test and 120 control subjects with similar anthropometric parameters. Results showed that the mean FVC (Liters) in the test subjects was significantly reduced (p<0.01) compared to the control. Mean FEV1 (liter) of the test group was significantly lower (p<0.001) than control. Result for FEV1% (Liters) and PEFR (L/min) in the test subjects was not significantly different compared to control. Percentage of oxygen saturation (SPO2%) in both control and test subjects were not significantly different. Dust levels (mg/m3) in the test sites was significantly higher (p<0.001) than in control sites. SO2, NO2 and H2S were significantly higher in test sites compared to control (p<0.05-p<0.01). There was a higher incidence of respiratory symptoms such as productive cough, sneezing etc in public waste workers. Public waste workers had a restrictive pattern of impairment caused likely by significantly high dust levels with SO2 level which exceeded the ambient levels as documented by the Federal Ministry of Environment in Nigeria

Caecal diverticulitis is an uncommon condition in western countries and is often confused with the diagnosis of acute appendicitis. A distinction between the two entities is almost made intraoperatively. The management of solitary inflamed caecal diverticulae is still controversial; it ranges from a conservative approach with antibiotics to a right hemicolectomy. We present a case of 27 year old female which presented to the emergency department with symptoms similar to acute appendicitis. However, a CT scan showed signs of perforated caecal diverticulitis, thus an ileocaecal resection was realized. Across our case and a literature review, we try to highlight the difficulty of a preoperative diagnosis of this rare clinical condition and to discuss essentially its surgical management

The breast is the most frequent site of cancer among women in both developed and in developing countries [1]. Breast cancer is the most frequent cause of cancer death in women from less developed countries and second most frequent (after lung cancer) among women in developed countries [1]. It is increasing in incidence in the developing world due to increased life expectancy, increased urbanization and the adoption of western lifestyles [2]. According to the World Health Organization (WHO), “Early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control” [2]. Breast cancer staging also takes into account cancer's grade; the presence of tumor markers, such as receptors for estrogen, progesterone and HER2; and proliferation factors.Standard screening for new and recurrent breast cancer involves clinical breast exam and breast imaging. Given the recognized differences in breast cancer incidence, subtypes, and prognosis among women , it is important to evaluate potential biomarkers in the landscape of breast cancer subtypes ranging from DCIS to triple-negative breast cancer (TNBC) to determine if a simple blood test can enhance the diagnosis of this disease and knowing about stage of disease, and helping in proper treatment. In this review we tried to discuss role of genetic panels in breast cancer management

Macro-vascular and micro-vascular complications of diabetes significantly cause morbidity and mortality among diabetic subjects in India. The study was to assess the prevalence of micro vascular complications of newly diagnosed type 2 diabetic subjects and to analyze the relationship of occurrence of micro vascular complications with its risk factors in a tertiary care teaching and multi specialty hospital. The targeted and opportunistic screening analysis shows that the mean age of diabetic subjects’ were 54.27±9.27 years and 72.09% of newly diagnosed cases. The overweight 37.20%, hypertension 30.23%, diabetic neuropathy 25.56%, diabetic retinopathy 11.62%, diabetic nephropathy 18.60% and in the present study, 55.81% of asymptomatic newly diagnosed type 2 Diabetes patients had at least one or more microvascular complications. Type 2 diabetes is characterized by a long asymptomatic period before it is diagnosed. In our study the results shows significant association of these risk factors in Type 2 diabetes and was treated as early as possible to decrease the progression of vascular complications

Background: Socioeconomic status (SES) and geographical proximity form dental care unit has been reported to be associated with lack of concern to dental health. Therefore, the present study was conducted to assess the relationship between SES and geographical factor affecting number of case reporting to the five different dental clinics across India. Materials and Methods: A probability sampling was done to select dental clinic among five major cities across the north India. After selecting the dental clinic a cross sectional study was conducted to assess the relationship between SES and geographical factor affecting number of case reporting to the selected dental clinic of major cities. All the subjects were evaluated and questioned regarding locality from where they arrived, there occupation and annual income to reach to the conclusion of their geographic location from clinic and socioeconomic status. This cross sectional study was carried for a period of six months. After collecting data from all five clinics unpaired t test was done to find out the significance of the study. Results: a total of urban classified patient in five clinics were 2672 whereas low socioeconomic and rural patients were 666. Comparison of mean Urban and Rural OPD frequencies per month over six months in various cities was made on the basis of unpaired t tests. The mean value for different cities between urban and rural population are as follow for Jaipur urban pt. were 43.17 and rural pt. 12.67. For Ahmadabad mean value for urban pt. 87 whereas rural pt. 21.67. For Nagpur and Pune mean value for urban pt. was 95.67 and 101.67 and for urban pt. 27.50 and 23.33. Lastly for Hyderabad mean value for urban pt. was 117.83 and rural pt. 25.83. Unpaired t test for all the five centres showed p value less than 0.001 concluding the difference among the group are highly significant. Conclusion: The dental health care needs are very high both in rural and urban areas in spite of basic facilities available in urban areas. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned. There is an obvious disparity among the rural and urban patients mobilization for dental care needs. Lack of awareness, transport facilities or poor economic condition may provide resistance for rural patients to avail dental care facilities

The term "esthetics" is borrowed from the Greek word "aesthesia", which means sensation or sensibility. It can be defined as "belonging to the appreciation of the beautiful". The relation of this term to dentistry has been differentiated from the word "cosmetic", which is derived from the Greek word "kosmos", or adornment. It is further stated that esthetic dentistry enhances the natural beauty of the mouth and face and that the term is used specifically to imply an improved relationship rather than a superficial one. This article reviews about principles for anterior dentition esthetic treatments