Detection of Dental Caries’ and Dermatoglyphics’ Association with Relative Enamel Thickness Using CBCT Images in Saudi Subpopulation: A Novel Approach

Background. Dental caries is the localized destruction of dental hard tissues (enamel and dentine). Decayed, Missing, and Filled Teeth (DMFT) index is the most commonly used dental caries index. Thickness of the outermost part of the tooth called the enamel is determined by the rate of deposition of enamel proteins. Relative enamel thickness (RET) gives a measure of enamel thickness with respect to dentine. Dental caries is influenced by a genetically determined factor called dermatoglyphics (DG). As the genes responsible for RET and DG lie on the same chromosome and develop during the same time of intrauterine life, it is biologically plausible to correlate RET and DG. Aims. This study consists of two primary aims: (1) to assess RET using cone beam computed tomography images and correlate it with caries and (2) to correlate RET with DG. Materials and Methods. 148 dental subjects were assessed for DMFT caries score and were categorized as Group 1 with DMFT = 0 and Group 2 with DMFT ≥ 1 . Following this, their DG pattern was recorded digitally. The CBCT images of these subjects were assessed for RET, and the data were analyzed statistically. Results. Mean RET in our sample population is 18.45 (SD 3.79) while mean DMFT is 5.34 (SD 5.13). Mean RET in Group 1 subjects was 19.82 (SD 4.05) while that in the Group 2 was 17.68 (SD 3.43). RET and DMFT showed a statistically significant negative correlation ( p = 0.007 ). The “Single Loop” DG characteristic showed a statistically significant difference between males and females ( p = 0.031 ). The “Simple Arch” type of DG was positively correlated with RET. Conclusion. This is the first in vivo study to assess RET using CBCT images and correlate with DMFT and DG. RET is inversely related to DMFT while directly proportional to the “Simple arch” DG pattern. Males and females differed in their “Single Loop” DG characteristic.

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Correlation of Tooth Contact Habit in Patients with Signs and Symptoms of Temporomandibular Disorders and Healthy Normal Subjects

Dental Journal of Advance Studies ◽

10.1055/s-0038-1671981 ◽

2014 ◽

Vol 02 (01) ◽

pp. 022-025

Author(s):

Subhash Vasudeva ◽

Asha Iyengar ◽

Nagesh Seetaramaiah

Keyword(s):

Temporomandibular Disorders ◽

Signs And Symptoms ◽

Normal Subjects ◽

Tooth Contact ◽

Normal Individuals ◽

Significant Difference ◽

History Of ◽

Males And Females ◽

Group 2 ◽

Group 1

Abstract Purpose: Temporomandibular disorders are among the common musculoskeletal conditions affecting the individual. Modern day lifestyle and work environment may introduce abnormal habits like constant tooth contact habit which may have a role in the pathogenesis of temporomandibular disorder. This study aimed to correlate the prevalence of tooth contact habits in individuals suffering from TMD and compare them with that of normal individuals without any signs and symptoms of TMD. Material and Methods: 505 individuals were included in the study. They were divided into 2 groups. Group 1 consisted of 255 individuals who presented with signs and symptoms of temporomandibular disorders and group 2 consisted of 250 normal individuals. Detailed case history with emphasis on habits of constant tooth contact was recorded. Fischer's t test was used to compare the results between the two groups. Results: In group 1,54.5% of males and 58.02% of females gave a history of tooth contact habit while in group 2 individuals 38.7% males and 39.8% females gave a history of this habit. There was no statistically significant difference between males and females of group 1 with regard to this habit. There was a statistically significant difference between group 1 and group 2 individuals (both males and females combined) with regards to this habit. (p= 0.0003) Conclusion: Individuals with temporomandibular disorders exhibited higher prevalence of tooth contact habit when compared to normal subjects.

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Caries Prevalence in 12-year-old Children from Plovdiv - a Multifactorial Regression Analysis

Folia Medica ◽

10.3897/folmed.62.e47894 ◽

2020 ◽

Vol 62 (1) ◽

pp. 159-164

Author(s):

Michael P. Onov ◽

Ani B. Beltcheva

Keyword(s):

Regression Analysis ◽

Statistical Analysis ◽

Dental Caries ◽

Health Assessment ◽

Caries Prevalence ◽

Etiological Factors ◽

Significant Difference ◽

Group 2 ◽

The City ◽

Group 1

Introduction: Dental caries is among the most important social diseases. The changes in caries prevalence occurring in different regions provide important information about the influence of etiological factors – primary and secondary, and about understanding the connections between the factors themselves.   Aim: The aim of this study was to investigate the prevalence of dental caries in 12-year-old children from Plovdiv, Bulgaria and the effect of etiological factors – single-factor and multifactorial influence.   Materials and methods: The study included 228 children divided into 2 groups: group 1 - children living in the city of Plovdiv, city proper (125 children), and group 2 - children living in the surrounding villages (103 children). A questionnaire with an attached written consent form for clinical examination was completed by the parents of each child with results recorded in the WHO Oral Health Assessment Form for Children. Statistical analysis of the recorded data was used to determine DMFT index for the two groups, percentage of caries-free children and the influence of etiological factors through regression analysis.   Results: Statistical analysis showed the DMFT scores as follows - 1.568 for city proper, 2.917 for surrounding villages. The caries-free children were 38.4% and 17.5% for group 1 and group 2, respectively. OHI is the highest predicting factor in a multifactorial regression analysis with over 19% predictive function.   Conclusion: There was statistically significant difference in caries prevalence and percentage of caries-free children between the city proper and the surrounding villages. Etiological factors have specific influence in the investigated age group.

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Effect of Rapid Maxillary Expansion on Upper Airway Morphology: A Retrospective Comparison of Normal Patients versus Patients with Enlarged Adenoid Tissue.

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-45.3.11 ◽

2021 ◽

Vol 45 (3) ◽

pp. 208-215

Author(s):

Xin Feng ◽

Stein Atle Lie ◽

Kristina Hellén-Halme ◽

Xie-Qi Shi

Keyword(s):

Nasal Obstruction ◽

Upper Airway ◽

3D Models ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Cross Sectional ◽

Computed Tomography Images ◽

Significant Difference ◽

Group 2 ◽

Group 1

Objectives The present study evaluated the effect of rapid maxillary expansion (RME) on the morphology of the upper airway (UA) by calculating cross-sectional areas and volumes and comparing the effect in patients with a normal-sized adenoid with the effect in patients with an enlarged adenoid. Study design: Seventeen patients met the inclusion criteria. We constructed 3D models of the UA on cone-beam computed tomography images to calculate cross-sectional areas and volumes at the levels of the nasopharyngeal, retropalatal, and retroglossal airways. Patients were divided into two groups: group 1 was comprised of patients with an adenoidal nasopharyngeal (AN) ratio < 0.6 and group 2 with an AN ratio ≥ 0.6. Paired samples t-tests assessed any area and volumetric changes of the UA after RME. Changes in degree of nasal obstruction, calculated as the AN ratio, was then compared for the two groups. An independent samples t-test compared volumetric changes in the nasopharynx between the two groups before and after RME. Results Changes in cross-sectional areas and volumes of the UA due to RME were not significant. The effects of RME on AN ratio (11 % vs 0 %) and nasopharyngeal volume (36.8 % vs 5.97%) were somewhat larger in group 2 patients who had adenoid-associated nasal obstruction compared with group 1 patients with a normal-sized adenoid; however, the differences were not significant. Conclusions After RME, the patients with an enlarged adenoid had more increases in nasopharyngeal volume compared with those with normal adenoid, despite there was no significant difference.

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In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽

10.1024/0301-1526/a000867 ◽

2020 ◽

Vol 49 (4) ◽

pp. 281-284

Author(s):

Atıf Yolgosteren ◽

Gencehan Kumtepe ◽

Melda Payaslioglu ◽

Cuneyt Ozakin

Keyword(s):

Vascular Graft ◽

Graft Infection ◽

Vascular Graft Infection ◽

Group 4 ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Prosthetic Vascular Graft Infection ◽

Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

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Tuberculosis of the meninges and central nervous system. Experience of clinical diagnostics in St. Petersburg for 50 years

MedAlliance ◽

10.36422/23076348-2020-8-1-14-24 ◽

2020 ◽

Vol 8 (1) ◽

pp. 14-24

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Medical Errors ◽

Clinical Diagnostics ◽

Lethal Outcome ◽

Significant Difference ◽

Group 2 ◽

Allergic Vasculitis ◽

Tuberculosis Meningitis ◽

Group 1

The clinic and diagnostics of tuberculosis meningitis (TM) in 926 patients treated in St. Petersburg hospitals in 1965–1994 (group 1) and in 1995–2018 (group 2) is presented. The TM clinic is demonstrated to be determined by the form of tuberculosis and its characteristic generalization nature in the presence of repeated waves of bacteremia and allergic vasculitis of greater or lesser severity. There is clinical peculiarity of TM in primary pulmonary tuberculosis and its early large-focal and late miliar generalization, as well as in hematogenous tuberculosis. In patients of the 1st and 2nd groups the TM clinic shows in some respects a noticeable similarity, in others — a significant difference. Despite the typical symptoms, early diagnosis of TM took place in less than 20% of patients. Clinical examples illustrating the unusual development of TM, contrasting with its usual course, are given. A number of objective and subjective factors contributing to the adverse evolution of TM and its lethal outcome are discussed. These include the peculiarity of modern tuberculosis, especially when associated with HIV infection, as well as medical errors associated with ignorance of the pathogenesis of tuberculosis and failure to comply with the minimum examination for tuberculosis.

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Two Adhesive Systems-effect on Adhesion to Tooth Structure

Revista de Chimie ◽

10.37358/rc.19.7.7389 ◽

2019 ◽

Vol 70 (7) ◽

pp. 2608-2613

Author(s):

Larisa Simona Deac ◽

Kamel Earar ◽

Adela Loredana Colceriu Burtea ◽

Alexandra Stefania Berghe ◽

Aurora Antoniac ◽

...

Keyword(s):

Adhesive Systems ◽

Hybrid Layer ◽

Tooth Structure ◽

Selective Etch ◽

Etch And Rinse ◽

Significant Difference ◽

Wisdom Teeth ◽

Group 2 ◽

Self Etch ◽

Group 1

This study evaluates and compares by dye penetration method and SEM photomicrographs the sealing obtained using two different classes of adhesive systems (etch-and-rinse and self-etch with selective etching) with SDR (Dentsply) bulk fill composite. 84 class V cavities were prepared on oral and vestibular face of 42 intact, freshly extracted wisdom teeth. The cavities were randomly divided in two groups and restored: Group 1 with prime &bond one select (Dentsply) and SDR (Dentsply) and Group 2 with prime&bond one Etch&Rinse (Dentsply) and SDR (Dentsply). Prime&bond one Select (Dentsply) is a single component adhesive and can be used in self etch mode, in selective enamel etch mode, or in etch-and-rinse mode. We chosen for this study the selective etch of the enamel mode. Prime&bond one Etch Rinse (Dentsply) is a universal etch-and-rinse one-bottle dental adhesive, designed to be used in two steps. The bulk fill composites are commonly used in modern dentistry due to their properties of low polymerization shrinkage and curing in layer of 4 mm depth, offering the practitioner a fast clinical procedure with good results. The results showed a good sealing at enamel and dentin margins with no statistically significant difference between adhesives, even though the mean of enamel infiltration was smaller for Group1. Furthermore the results show that there were differences between the two groups, for the infiltrations at the enamel, the values of microleakage being arithmetically higher for Group 1, but with no statistically difference between the two groups.SEM images showed for both groups a good adhesion surface with the tooth, but the hybrid layer of the total-etch adhesives is different from the hybrid layer formed by self etch adhesives, in terms of thickness, uniformity. In conclusion both adhesive systems have equivalent sealing qualities and can be successfully used with SDR.

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Reducing Gingivitis Remotely using the iGAM mHealth app (part 2): Prospective Observational Study (Preprint)

10.2196/preprints.24955 ◽

2020 ◽

Author(s):

Guy Tobias ◽

Assaf B Spanier

Keyword(s):

Oral Health ◽

Tooth Loss ◽

Prospective Observational Study ◽

Dental Clinics ◽

Significant Difference ◽

Observational Cohort ◽

Group 2 ◽

And Behavior ◽

Oral Hygiene Habits ◽

Group 1

BACKGROUND Gingivitis is a non-painful, inflammatory condition that can be treated with home remedies. Left untreated gingivitis can lead to tooth loss. Periodic dental examinations are important for early diagnosis and treatment of gum diseases. In order to contain the spread of the corona virus, governments, including in Israel, have restricted movements of their citizens which has caused routine dental checkups to be postponed. OBJECTIVE This study aimed to examine the ability of an mHealth app- iGAM to reduce gingivitis. METHODS A prospective observational cohort study was performed, 160 unpaid participants were divided into 2 equal groups and downloaded the iGAM app. Group 1 photographed their gums weekly for eight weeks. Group 2 photographed their gums at the time of recruitment and 8 weeks later. After photo submission, the participants received the message "It is recommended to read the information contained within the app regarding maintaining oral hygiene habits". A single blinded researcher examined the images and scored them according to the Modified Gingival Index (MGI). RESULTS The average age of group 1 was 26.77 (S.D. ± 7.43), and 28.53 (S.D. ± 10.44) for group 2. The majority were male (74.7% in group 1 vs. 66.7% in group 2), most participants described themselves as "secular", most were "single", non-smokers (74.7% vs. 78.4%) and did not take medications (85.3% vs. 78.4%). 126 subjects completed the study. A statistically significant difference (P <.001) was found in the dependent variable (MGI) in a linearly negative manner. As time passed, the gum condition improved, there were significantly lower gingivitis scores in group 1 (M = 1.16, S.D. ± 1.18) compared to group 2 (M = 2.16, S.D. ± 1.49), after eight weeks. Those with more recent dental visits had a lower MGI (p = .037). No association was found between knowledge and behavior, most participants were familiar with the recommendations for maintaining oral health, yet they only performed some. CONCLUSIONS A dental selfie taken once a week using an mHealth app (iGAM) reduced the signs of gingivitis and promoted oral health. During the current pandemic where social distancing recommendations may be causing people to avoid dental clinics, this app can remotely promote gum health. CLINICALTRIAL The protocol was approved by Hadassah research ethics committee (IRB, 0212-18-HMO)

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Scanning Electron Microscopy Analysis of the Anterior Capsulotomy Edge: A Comparative Study between Femtosecond Laser-Assisted Capsulotomy and Manual Capsulorhexis

Journal of Ophthalmology ◽

10.1155/2018/8620150 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Daniele Tognetto ◽

Chiara De Giacinto ◽

Alberto Armando Perrotta ◽

Tommaso Candian ◽

Alessandro Bova ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Femtosecond Laser ◽

Comparative Study ◽

Surface Irregularity ◽

Significant Difference ◽

Group 2 ◽

Cut Surface ◽

Scanning Electron ◽

Group 1

Purpose. To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). Setting. Eye Clinic, University of Trieste, Italy. Design. Experimental comparative study. Methods. 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. Results. All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p<0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p<0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). Conclusions. Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC.

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Isometric Handgrip Exercise Training Improves Spirometric Parameters and Pulmonary Capacity

Pathophysiology ◽

10.3390/pathophysiology28030022 ◽

2021 ◽

Vol 28 (3) ◽

pp. 328-338

Author(s):

Ogbutor Udoji Godsday ◽

Nwangwa Eze Kingsley ◽

Nwogueze Bartholomew Chukwuebuka ◽

Chukwuemeka Ephraim ◽

Ezunu Emmanuel ◽

...

Keyword(s):

Pulmonary Function ◽

Isometric Exercise ◽

Handgrip Exercise ◽

Isometric Handgrip ◽

Post Exercise ◽

Significant Difference ◽

Isometric Handgrip Exercise ◽

Group 3 ◽

Group 2 ◽

Group 1

Decline in normal physiological pulmonary function has been attributed to premorbid conditions such as prehypertension. Research evidence suggests that physical activity reduces age-related decline in pulmonary function and improves the efficiency of the lungs in prehypertensive patients. However, there is a scarcity of data evidence relating to isometric exercise and pulmonary function. Furthermore, the interrelationship between the intensity and duration of isometric exercise and pulmonary function in these patients is still uncertain. Therefore, this study was undertaken to investigate the effect of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. To determine the effectiveness of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. A quasi experiment using a pre- and post-exercise method was carried out in two out-patients hospital settings. The sample comprised 192 sedentary pre-hypertensive subjects, aged between 30–50 years, that were randomly distributed into three groups of 64 participants each. The subjects performed, for 24 consecutive days, an isometric handgrip exercise at 30% Maximum Voluntary Contraction (M.V.C.). At the end of the 24 days, group one (GP1) discontinued, while group two (GP2) continued the exercise protocol for another 24 consecutive days and group three (GP3) continued with the exercise protocol for another 24 consecutive days but at 50% M.V.C. Determinants of lung function (outcomes) were Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), FEV1/FVC Ratio and Peak Expiratory Flow Rate (PEFR). The study shows that there was no statistically significant difference in the pre- and post-exercise outcomes for FEV1, FVC, FEV1/FVC Ratio and PEFR after 24 days for group 1. In group 2, there was a statistically significant difference in the FVC [(mean = 0.12 ± 0.12), (p = 0.002)], FEV1 [(mean = 0.15 ± 0.17), (p = 0.003)] and PEF [(mean = 0.85 ± 0.35), (p = 0.001)] after 48 days. In group 3, there was a statistically significant difference (p = 0.001) in all the outcomes assessed after 48 days. There was a between groups difference in favour of group 2 compared with group 1 for outcomes of FEV1 [(mean = 0.142 ± 0.68), (p = 0.005)] and PEF [(mean = 0.83 ± 0.19), (p = 0.0031)]. There was statistically significant difference in favour of group 3 compared to group 2, by increasing the exercise intensity from 30% to 50% M.V.C., for outcomes of FVC [mean change = 0.10 ± 0.052), (p = 0.005)], FEV1/FVC [mean change = 3.18 ± 0.75), (p = 0.017)] and PEF [(mean change = 0.86 ± 0.35), (p = 0.001)] after 48 days. Isometric handgrip exercise (after 48 days at 30% to 50% M.V.C.) improves outcomes of pulmonary function capacity in adults with prehypertension. Meanwhile, duration and/or increase in intensity of the isometric effort significantly contributed to the affects attained.

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Hybrid cardiac rehabilitation program as a potential enhancer of adherence to cardiac rehabilitation in smoking patients with coronary heart disease - a retrospective single-centre analysis

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.347 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

M Cabral ◽

R Santos ◽

F Januario ◽

A Antunes ◽

R Fonseca-Pinto

Keyword(s):

Mental Health ◽

Cardiac Rehabilitation ◽

Smoking Status ◽

Rehabilitation Program ◽

Anxiety And Depression ◽

Cardiac Rehabilitation Program ◽

Phase 2 ◽

Significant Difference ◽

Group 2 ◽

Group 1

Abstract Funding Acknowledgements Type of funding sources: None. Cardiac rehabilitation (CR) has well known beneficial effects on physical capacity, health-related quality of life, morbidity and mortality following an acute cardiac event. It is also known that smoking status is a powerful predictor of recurrent cardiovascular disease events. However, it has been noted that smoker patients may be less likely to access or complete CR. The aim of this study was to determine the levels of anxiety and depression and its improvement, depending on the smoking status of patients with coronary artery disease (CAD) on phase 2 of the Cardiac Rehabilitation Program (CRP). Additionally, we intend to investigate the mental health impact on smoker patients" group in conventional CR versus telemonitored CR. A retrospective study was conducted and patients in CRP between 2017 and 2020 were included. Patient selection and information collection were obtained through medical records. The outcomes of anxiety and depression were evaluated through the Hospital Anxiety and Depression Scale (HADS). Patients were divided into two groups: group 1 for non-smokers or ex-smokers and group 2 for smokers. For group 2 patients, a sub-analysis was performed for patients following the conventional CR versus the telemonitored CR, with the use of MOVIDA mobile application. Variables were analysed in the beginning (T0) and in the end (T1) of phase 2, around 3 months after. Group comparisons tests and statistical analysis were performed using SPSS software v25.0. A p-value less than 0.05 is statistically significant. We analysed 107 patients, which 93 of these were assiduous and 69 concluded the phase 2 of CRP: 39 patients in group 1 and 30 patients in group 2. Two groups have similar baseline characteristics, except for the higher presence of diabetes (p = 0.02) in group 1. It was noted an improvement in both anxiety and depression items for group 1 (p < 0.01 for both), but only for anxiety item for group 2 (p = 0.03). In subgroup analysis, we observed no improvement for smoking patients following the conventional CR for both anxiety and depression items (p = 0.60 and p = 0.71, respectably) versus a significant difference in telemonitored CR patients (p = 0.02 and p = 0.04). We hypothesise that, when compared to conventional CR, cardiac telemonitored exercise using modern communication methods may result in an improved mental health state among smoking patients, which can lead to a better adherence for CRP. Further studies including more patients and phase 3 of CRP are needed to confirm these results.

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