PORTAL VEIN AND LIVER BARIUM EMBOLISM

Background. An upper and lower gastrointestinal (GI) series is an available and informative diagnostic test. Side effects are extremely rare. Objective. To present a case description of portal vein and liver barium embolism with a fatal outcome and explain the mechanism of its occurrence. Material and methods. The clinical manifestations, laboratory and instrumental findings, as well as autopsy of a female patient who died after lower GI radiography were analyzed. Results. To exclude intestinal obstruction, the patient underwent a barium follow through. Three days later, during X-ray computed tomography, barium and gas were detected in the inferior mesenteric vein, portal vein and its intrahepatic branches. During colonoscopy, diverticula of the sigmoid colon were detected, but the localization of the intestinalvenous fistula wasn’t determined. Conservative surgery failed and the death occurred 15 days after radiography. Conclusions. The autopsy revealed that the site of entry for the development of barium embolism as well as for gas, were diabrotic veins in peridiverticular abscesses localized in pericolic tissue.

Determining the Impact of Platelet-rich Plasma Therapy on Short-‎term Postoperative Outcomes of Pediatric ‎Tonsillectomy Patients in Egypt

Background: Tonsillectomy is considered one of the most common major operations performed in pediatric population. Unfortunately, tonsillectomy is often associated with severe pain that may delay the patient discharge and influence his ability to return to the normal daily activities together with a 2–4% risk of hemorrhage. Among promising healing promoting agents is Platelet-rich plasma (PRP). It is considered as a potential adjuvant therapy improving the healing of surgical wounds and contains multiple growth and healing factors that are released upon their activation. Methods: This was a prospective randomized controlled study carried on forty patients who underwent tonsillectomy alone or adenotonsillectomy. In each patient, PRP was used on one side " test side " and other side was used as a control. The test side was randomly allocated in all patients, so the results will be of the 40 patients, total sides 80, (test side 40; 20 right side and 20 left side). Results: Our results revealed that mucosal healing was noted to be better in PRP treated side, particularly on 5th and 10th post-operative day, with documented less incidence of secondary post-operative hemorrhage. Pain scores were less on the PRP treated side through the post-operative period, but were statistically significant only on the 5th day postoperative. Conclusions: The preliminary results from this study, supported by literature, have revealed that PRP was beneficial in the amelioration of post-tonsillectomy pain, improvement of healing and bleeding risk in pediatric tonsillectomy patients.

Mouthwash with Active Oxygen (blue®m) Reduces Postoperative Inflammation and Pain

The aim of this case series was to evaluate the effects of blue®m mouthwash on oral surgical wounds. Eleven patients underwent bilateral preprosthetic surgery and were instructed to apply the product only to the right side of the surgery. In this way, the right side corresponds to the test side and the left side (place without applying any type of solution) to the control side. After seven days of using the product (3 times a day), the following parameters were evaluated by means of a visual analogue scale: pain, changes in taste, and acceptance by the patient. Then, the level of tissue inflammation was assessed, by the number of pixels, using ImageJ® software. The main results show that the blue®m mouthwash was widely accepted by patients, reducing their pain. The number of inflammation pixels was lower on the test side ( p < 0.05 ), indicating improved healing. It is suggested that blue®m mouthwash positively influences tissue healing reducing pain and the postsurgical inflammatory process; however, randomized clinical trials should be done to prove this clinical observation.

In vivo investigation of diode laser application on red complex bacteria in non-surgical periodontal therapy: a split-mouth randomised control trial

Assessment of the efficacy of a single 810 nm diode laser application as an adjunctive treatment modality during the first intervention of non-surgical periodontal therapy (NPT). 25 patients diagnosed with chronic periodontitis underwent a split-mouth randomised control trial. The periodontal pockets of the test quadrants were treated with an 810 nm diode laser as an adjunct to NPT (Picasso GaAlAs; AMD Lasers). The laser was set at 1.0 W continuous wave, 400 µm tip, 796 W/cm2 peak power density and a 32 J/cm2 energy density. Therapeutic outcomes were evaluated based on the clinical parameters, which included probing pocket depth, recession, clinical attachment level, full mouth plaque score, full mouth bleeding on probing and tooth mobility. The baseline bacterial collection was completed from the periodontal pockets and then re-evaluated at 6 weeks. Clinical parameters demonstrated no statistical difference, with the exception of a statistically significant (P < 0.05) reduction in bleeding on probing for the test side. The test side resulted in a statistical increase of Capnocytophagaspecies and Treponemadenticola. The single application of the diode laser did not significantly improve the bacterial nor the clinical parameters in patients with chronic periodontitis.Trial registration number: PACTR201909915338276.

Epinephrine penetrates through gingival sulcus unlike keratinized gingiva and evokes remote vasoconstriction in human

Background It has been demonstrated in non-oral tissues that the locally evoked vasoconstriction could elicit remote vasoconstriction. This study aimed to investigate the spreading vasoconstrictor effects of epinephrine in the gingiva. Methods Gingival blood flow (GBF) was measured by laser speckle contrast imager in 21 healthy volunteers. In group A, two wells were fabricated from orthodontic elastic ligature and placed 2 mm apically to the free gingival margin at the mid buccal line of 12 (test side) and 21 (control side) teeth. The GBF was measured in the wells and tightly apical, coronal, distal and mesial to the wells. In group B, the wells were made on the buccal surface of the same teeth, including the gingival sulcus. Four regions were selected for measurement from the gingival margin reaching the mucogingival line (coronal, midway1, midway2 and apical). After the baseline recording, 3 µg epinephrine was applied into the test, and physiological saline into the control well. The GBF was recorded for 14 min. The gingival thickness was measured with a PIROP Ultrasonic Biometer. Results In group A, the GBF did not increase or decrease after the application of epinephrine. In group B, the GBF significantly decreased in all regions of the test side and remained low for the observation period. The vasoconstriction appeared with delays in more apical regions (at min 1 in the coronal and the midway1, at min 2 in the midway2, at min 4 in the apical region). Similarly, the amount of the decrease at 14 min was the largest close to sulcus (− 53 ± 2.9%), followed by the midway1 (− 51 ± 2.8%) and midway2 (− 42 ± 4.2%) and was the lowest in the apical region (− 32 ± 5.8%). No correlation was found between GBF and gingival thickness. Conclusion Epinephrine could evoke intense vasoconstriction propagating to the mucogingival junction, indicating the presence of spreading vasoconstriction in the human gingiva. The attached gingiva is impermeable to epinephrine, unlike the gingival sulcus. This trial was registered in ClinicalTrials.gov titled as Evidence of Spreading Vasoconstriction in Human Gingiva with the reference number of NCT04131283 on 16 October 2019. https://clinicaltrials.gov/show/NCT04131283

Pengaruh aplikasi gel teh hijau (Camellia sinensis) terhadap kadar total antioxidant capacity (TAOC) sebagai perawatan tambahan dari skeling dan root planing pada pasien dengan periodontitis kronisEffect of green tea (Camellia sinensis) gel application on the total antioxidant capacity (TAOC) levels as adjunct to scaling and root planing in patients with chronic periodontitis

Pendahuluan: Mekanisme peradangan periodontitis kronis menghasilkan reaksi oksidasi, diketahui melalui kadar total antioxidant capacity (TAOC) cairan sulkus gingiva. Teh hijau dapat menghambat bakteri patogen periodontal sehingga kerusakan jaringan periodontal tidak bertambah parah. Tujuan penelitian adalah menganalisis kadar TAOC sebelum dan sesudah skeling dan root planing disertai gel teh hijau sebagai antioksidan. Metode: Jenis penelitian eksperimen semu, rumus ukuran sampel untuk menguji perbedaan dua rata-rata data tidak berpasangan, setiap subyek memiliki poket ≥ 5 mm, dikelompokkan sisi uji (n=14) dan sisi kontrol (n=14) (split mouth). Pengambilan cairan sulkus gingiva dilakukan pada hari ke-0, 15, dan 30, menggunakan metode absorbing paper strip dengan cara intracrevicular. Kedua sisi dilakukan skeling dan root planing, sisi uji diberikan gel. Hasil: Perbandingan kadar TAOC antara sisi kontrol dan sisi uji pada hari ke-0 (p=0,986), hari ke-15 (p=0,836), dan hari ke-30 (p=0,371) menunjukkan tidak terdapat perbedaan bermakna (p-value>0,05). Perbandingan rerata selisih kadar TAOC dalam kedua kelompok antara hari ke-0 dengan ke-15 (p=0,946), hari ke-0 dengan hari ke-30 (p=0,504), serta hari ke-15 dengan hari ke-30 (p=0,811) jugwa menunjukkan tidak terdapat perbedaan bermakna. Simpulan: Tidak terdapat pengaruh aplikasi gel teh hijau (Camellia sinensis) terhadap kadar total antioxidant capacity (TAOC) pada perawatan periodontitis kronis berupa skeling dan root planing.Kata kunci: Gel teh hijau, periodontitis kronis, skeling dan root planing, total antioxidant capacity (TAOC). ABSTRACTIntroduction: The inflammatory mechanism of chronic periodontitis produces an oxidation reaction, measured through the level of total antioxidant capacity (TAOC) of the gingival crevicular fluid. Green tea can inhibit periodontal pathogenic bacteria so that periodontal tissue damage will not worsen. This study was aimed to analyse the levels of TAOC before and after scaling and root planing with green tea gel as an antioxidant. Methods: The research was quasi-experimental. The sample size formula was used to test the difference between two unpaired data means. Each subject has a pocket ≥ 5 mm, grouped by the test side (n = 14) and the control side (n = 14) (split-mouth). The gingival crevicular fluid was collected on days 0, 15, and 30, using the intracrevicular method with absorbing paper strips. Both sides were treated with scaling and root planing, and the test side was administered with the green tea gel. Results: Comparison of TAOC levels between the control side and the test side on day 0 (p = 0.986), day 15 (p = 0.836), and day 30 (p = 0.371) showed no significant difference (p-value > 0.05). Comparison of the mean difference of the TAOC levels in two groups between day 0 with day 15 was p = 0.946, day 0 with day 30 was p = 0.504, and day 15 with day 30 was p = 0.811; which also showed no significant difference. Conclusion: There is no effect of green tea gel (Camellia sinensis) application on the Total Antioxidant Capacity (TAOC) level in chronic periodontitis treatment in the form of scaling and root planing.Keywords: Green tea gel, chronic periodontitis, scaling and root planing, total antioxidant capacity (TAOC).

Design and Analysis on an Optimized Interface Algorithm for Real-Time Integrated Simulation System of Renewable Energy and the Power Grid

The interface algorithm is critical for accuracy of the real-time integration simulation system of renewable energy and the power grid. To improve the overall performance of the existing interface algorithms, this paper proposes an optimized interface algorithm based on the auxiliary damping impedance method interface current feedback. We explain in detail the implementation principle of the new interface algorithm and the calculation method of impedance matching and also provide a parallel timing control logic. Using the new interface algorithm, we derive equations for voltage and current of the digital simulation system side and the device under test side and also compare it with the naturally coupled system without interface delay. Finally, we verify the accuracy of the new interface algorithm via establishing a complete model of the real-time integration simulation system with a wind turbine and the power grid. The results show that the accuracy can be improved 95% in the digital simulation system side and 17% in the device under test side by using the proposed interface algorithm in this paper.

The Effect of Green Betle Leaf Gel (Piper Betle Leaf) to Total Antioxidant Capacity (TAC) Level after Scaling and Root Planing (SRP) Treatment

Green betel leaf gel (Piper betle leaf) has an antimicrobial, antiseptic and antioxidant activity. An imbalance between antioxidants and ROS in the oral cavity have been implicated as one of the progressive or pathogenic factor for periodontal disease. Antimicrobial topical agent delivery may be provided as a supportive therapy for periodontal treatment after scaling and root planing. The purpose of this research is to analyze the effect of green betle leaf gel (Piper betle leaf) to Total Antioxidant Capacity (TAC) level gingival crevicular fluids after scaling and root planing treatment in chronic periodontitis patients. This research is a quasi experimental with pretest and posttest, split mouth. A total of 14 subjects followed this study. The parameters measured were TAC levels gingival crevicular fluids before and after treatment with ELISA examination. Green betel leaf gel was applied to the pocket on the test side after scaling and root planing. Data analysis using Wilcoxon test with p <0.05, and Mann-Whitney test with p <0.05. TAC levels of gingival crevicular fluids increased on day 14 on both sides, on the test side there was a significant increase (p = 0.002) while on the control side the increase was not significant. Green betel leaf gel has an effect to increase TAC level gingival crevicular fluids after scaling and root planing in chronic periodontitis patients.

RADIATING THE WAY TO DESENSITIZATION

INTRODUCTION Dentinal hypersensitivity is a common clinical condition and the treatment outcome is not consistently successful with any particular treatment modalities. Two chief methods of treatment of dentinal hypersensitivity are tubular occlusion and blockage of nerve activity. Clinicians have used many materials and techniques to treat dentinal hypersensitivity. Research has shown that Lasers effectively occlude the dentinal tubules leading to a decrease in dentinal tubule permeability, thus reducing hypersensitivity. AIM AND OBJECTIVE To evaluate the efficacy of Diode laser in dentinal hypersensitivity. MATERIALS AND METHODS The desensitizing effect of the laser was assessed in a split mouth study. 10 patients underwent the Diode laser therapy. In the test sites effect of laser application was evaluated at 30 sec, 15 mins and 7 days, whereas in the control group sham laser was used with the similar protocol as test side. Pre and post-operative score for sensitivity was recorded on a VAS scale, at 30 sec, 15 mins and 7 days based on response of the patient to the cold air blast. RESULTS / CONCLUSION Diode lasers can be used as an effective treatment option for desensitization. Key Words Hypersensitivity Tubular Occlusion, Tubule Permeability

Effectiveness of Low-Level Laser Therapy during Tooth Movement: A Randomized Clinical Trial

The present study evaluated the effects of low-level laser therapy (LLLT) by means of a diode laser in accelerating orthodontic tooth movement (OTM). After extraction of the first upper premolars for orthodontic purpose, 82 maxillary canines which needed distalization were analyzed in 41 enrolled patients (21 males, 20 females, mean age 13.4 ± 2.1 years). On all experimental sites, an orthodontic force of 50/N was applied by a nickel-titanium (NiTi) closed coil spring (G&H, Franklin, IN, USA) in order to obtain the space closure. Using a split mouth randomized design, the test side was treated using a diode laser (Wiser Laser Doctor Smile, Brendola, Italy) operating at 810 nm wavelength in continuous wave mode at both the buccal and palatal side on three points/side (distal, medial and mesial) (1 W output power, continuous wave of 66.7 J/cm2, energy density of 8 J) at baseline and at 3, 7, and 14 days and every 15 days until the space closed. On the control side, the opposite selected canine was treated only using orthodontic traction. The primary outcome chosen was the overall time needed to complete the levelling and closing space, measured on a study cast. The secondary outcome chosen was the evaluation of pain levels related to tooth traction, using a Visual Analogue Scale (VAS), recorded at 3, 7, and 14 days after treatments. The mean space closures of the maxillary canines were comparable between groups [Test, 4.56 mm (95% CI 3.9–4.8); Control, 4.49 mm (95% CI 3.8–4.7), p = 0.456]. The laser group yielded less mean time [84.35 ± 12.34 days (95% CI 79.3–86)] to accomplish space closure compared to the control group [97.49 ± 11.44 days (91.7–102.3)] (p < 0.001). The test side showed a significant reduction in the average range of dental pain at 3 [Test, 5.41 (95% CI 5.1–5.6); Control, 7.23 (95% CI 6.9–7.6), p < 0.001], 7 [Test, 4.12 (95% CI 3.8–4.7); Control, 5.79 (95% CI 5.4–5.8), p < 0.001], and at 14 days [Test, 2.31 (95% CI 1.8–2.3); Control, 3.84 (95% CI 3.3–4.2), p < 0.001] after treatment (p < 0.001). This study demonstrates that the use of LLLT therapy was effective in accelerating tooth movement and reducing pain levels related to OTM.